LA County CMS/ DMEPOS Fraud and Abuse/ medical suppliers with CPO v. medical suppliers with other provider

LA County CMS/ DMEPOS Fraud and Abuse/ medical suppliers with CPO v. medical suppliers with other provider

Eric Hammerschmidt, CPO

3/17/2008

According to OEI - 0 9 - 0 7 - 0 0550 Los Angeles County Medicare Supplier
Standards document there is rampant fraud and abuse within the DMEPOS
Industry in LA county. After a damning report of abuse, fraud and
noncompliance with CMS supplier standards the Inspector General Daniel
Leverson is given six recommendations to cut down on these abuses from Kerry
Weems Acting Administrator. In the report she addresses: 1. Unannounced CMS
visits 2. Background checks 3. Fraud risk reduction 4. More vigorous
prepayment reviews 5. More frequent reenrollment and 6. Strengthening
standards of minimum hours of operation and inventories, all of these being
valid if you are not cheating the system. Also provided in this document
(yet not listed in the letter to Inspector General Daniel Leverson) is a
breakdown of the offenses listed by the staff employed at the facility
inspected. Below is a list of their categories and non compliance rates.
The numbers are staggering and it appears to me that the problematic
industry is very recognizable. Again these numbers were not included in the
synopsis to Inspector General Daniel Leverson.

 

Pharmacy 11.1% non compliant

Medical Supply other 86.1% non compliant

Medical Supply with CPO 0.0% non compliant

Medical Supply with CP 0.9% non compliant

Medical Supply with CO 0.9% non compliant

 

As I said the numbers are staggering. It seems to me that the problem does
not involve those educated trained professionals providing quality Orthotic
and Prosthetic care. It seems to me that CMS and the Office of the
Inspector General should look into differentiating the two groups under
different regulation guidelines. Accreditation bodies such as ABC and CARF
ensure there is a difference between the two I will be sending an email to
Inspector General Daniel Leverson. His email is <Email Address Redacted> if
you choose to do the same.

 

Eric Hammerschmidt CPO

 

Ps. Remember that CMS has an open period for comments of new proposed
regulations through March 25. I hope that you all will have time to review
them and comment, if you feel the necessity to do so. Below is the link
that takes you directly to the web site.

 

 < <URL Redacted>>
<URL Redacted> Once you click the link on the top of
the page, a page pops up entitled, Document Details. Under Views you
can select either the pdf or html documents. Below that button is once
labeled Add Comments for you to submit your comments if you wish.

 

I've been told that CMS has a new address for where to send your comments,
but I am not sure so I would send them to the one posted on their website
AND the one they gave the 10 accrediting organizations (today) just to make
sure they get them. Here they are:

the one on the CMS web site: <mailto:<Email Address Redacted>>
<Email Address Redacted>

the one we just got: <mailto:<Email Address Redacted>>
<Email Address Redacted>