To prevent fraud, CMS has revoked billing privileges of 1,139 DMEPOS suppliers as part of the DMEPOS High-Risk Suppliers Demonstration. This project began in October 2007 and focuses on DMEPOS suppliers in South Florida and the Los Angeles metropolitan area. These suppliers, who were paid a combined total of $265 million between calendar years 2005 and 2007, lost their billing privileges for not re-enrolling in the Medicare program and not meeting Medicare's supplier standards.

CMS is continuing to fight waste, fraud and abuse by home health suppliers in the Dade County, Fla., area by suspending payments and taking other payment and review actions. On Oct. 6, CMS initiated efforts to address potential waste, fraud and abuse by suspending payments to 10 home health agencies and is continuing to review claims and payments to other agencies as resources allow.


In addition to suspending payment, CMS is:

-Implementing extensive pre- and post-payment review of claims submitted by ordering/referring physicians;

-Validating claims submitted by physicians who order a high number of certain items or services by sending follow-up letters to these physicians;

-Verifying the relationship between physicians who order a large number of home health services and the beneficiaries for whom they ordered those services; and

-Identifying and visiting high risk beneficiaries to ensure they are appropriately receiving the services for which Medicare is being billed.

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