Medicare fleeced on diabetes test strips

Multi-Millions lost by Medicare on diabetes claims

June 19, 2012
3Comments

Woman using diabetes test kit
http://washingtonexaminer.com/author/mark-tapscott
Four Medicare contractors wrongly paid three of every four audited reimbursement claims for test strips and lancets commonly used by diabetes patients, at a cost to taxpayers in excess of paid more than $271 million, according to the U.S. Department of Health and Human Services Inspector-General.
The HHS IG audited 400 claims paid in 2007, and found that only 97, or 24 percent, were properly documented, as required by Medicare. Of the remaining 303, 222 of them paid for too many supplies without providing required justifications, 117 had no documentation of refill orders, 90 lacked physician documentation, and there was no proof of delivery for 33 claims.
Errors were made on 76 percent of the audited claims because, according to the HHS IG, "because the contractors did not have controls to ensure that claims for test strips and/or lancets complied with certain Medicare documentation requirements" for the most frequently submitted claims or for those with overlapping service dates for the same person.
"The contractors could have saved Medicare an estimated $209 million for CY 2007 if they had had controls to ensure that claims for test strips and/or lancets complied with certain Medicare documentation requirements. Adequate controls are important to program integrity because they help to prevent improper payments to suppliers for test strips and lancets. Unless the contractors implement system edits to identify for further review high utilization claims and claims that have overlapping service dates for the same beneficiary, they are likely to continue to make improper payments to suppliers," the IG report said.
Medicare pays an estimated $1.2 billion annually on reimbursements for diabetes-related test strips and lancets, according to the IG.
Acting Medicare and Medicaid Services Administrator Marilyn Tavenner agreed with the IG report and recommendations and said fixes are being implemented. She did not, however, provide an estimate of the cost of those fixes or when they would be fully implemented.

Unbelievable. Actually it isn't but what else can I say.

My guess is that the screwed up businesses are somehow affiliated with the criminals in Washington. Screwed up bureaucrats giving business to their screwed up friends in exchange for campaign contributions. Follow the money. There is also an outside chance that the paperwork to follow to get reimbursed is so monumental, that only 24% of the contractors can figure it out.

That being said, the "geniuses" in the gubmit who approve and pay the reimbursements, are so clueless about their jobs that they cannot see when a request is improperly filed. No wonder Obummer wants to expand the gubmit...to throw more shit against the wall in hopes they can find a few people who can actually do their fucking job. This is just ONE example of how fucked up our gubmit is. A fish stinks from the head.

If you have ever tried to deal with all the red tape involved in any government program you can understand some of the errors (ever tried to figure out IRS tax forms?) and some of the stuff that you have to do or have on hand is really dumb. To sell our customers blood glucose test strips/lancets, etc. Every one in the pharmacy has to take a yearly test and you have to make 100% on it, you have to have an escape plan in case of emergency with a map (the pharmacy has 1 door only- I told the inspector that I didn't need an escape plan and neither did my employees , anybody that was too stupid to get out in case of a fire had been fired long ago) you are subject to random inspections to make sure that you are doing everything right (no big deal but if you didn't dot all the I's and cross all the T's they would fine you or refuse payment or take back money for stuff that you already sold). The patient had to fill out a multi-page form to get on the program and the doctor had to write the Rx with specific brand of strip, number of strips per day and a diagnosis code for the patient's disease and it had to be renewed with all that info or you broke the law. All this and you made $1.80 on a 50 or 100 dollar sale. Now do you see why Obamacare will be a major snafu. And you may not get your money for months due to slow government pay.