Review of Medicare Payments to D and M Sales, LLC, for Power Mobility Devices for Calendar Years 2006-2008

摘要

D and M Sales, LLC (D and M Sales), is a durable medical equipment supplier in Honolulu, Hawaii. During calendar years (CY) 2006 through 2008, Medicare paid D and M Sales 968,880 for 246 PMDs and associated accessories. We reviewed a judgmental sample of 30 claims totaling 117,765, which consisted of 99,945 for PMDs and 17,820 for associated accessories. We contacted Noridian Administrative Services (Noridian), the DME MAC that processed and paid D and M Sales Medicare claims, to evaluate 27 of the 30 claims for compliance with documentation requirements for medical necessity. Our objective was to determine whether D and M Sales claimed Federal reimbursement for PMDs and associated accessories in accordance with Medicare requirements.