Medicare claims (1 - 3 of 3 items) in Past Year
Medicare: CMS's Round 2 Durable Medical Equipment and National Mail-order Diabetes Testing Supplies Competitive Bidding Programs
GAO-16-570: Published: Sep 15, 2016. Publicly Released: Oct 17, 2016.
The number of beneficiaries receiving durable medical equipment (DME) items covered under the competitive bidding program (CBP) generally decreased after implementation of two CBP phases that began July 1, 2013—round 2 and the national mail-order program for diabetes testing supplies. Under the CBP, (administered by the Centers for Medicare & Medicaid Services (CMS)), only competitively selected...
Medicare Program: Continued Action Required to Address Weaknesses in Provider and Supplier Enrollment Controls
GAO-16-703T: Published: May 24, 2016. Publicly Released: May 24, 2016.
In June 2015 and April 2016, GAO reported on CMS's implementation of enrollment-screening procedures that the Centers for Medicare & Medicaid Services (CMS) uses to prevent and detect ineligible or potentially fraudulent providers and suppliers from enrolling into its Provider Enrollment, Chain and Ownership System (PECOS). GAO identified weaknesses in CMS's verification of provider practice locat...
Medicare: Opportunities Exist to Recover Potential Overpayments to Providers with Criminal Backgrounds
GAO-16-365R: Published: Apr 13, 2016. Publicly Released: Apr 13, 2016.
Opportunities exist for the Centers for Medicare & Medicaid Services (CMS) to recover about $1.3 million in potential overpayments to 16 out of 66 potentially ineligible providers with criminal backgrounds who were enrolled in Medicare before CMS implemented more extensive background-check processes in April 2014. These 16 providers had Medicare claims paid to them while they were potentially inel...