OIG follows up on previous audit to verify compliance

After an OIG audit, providers receive recommendations on resolving issues uncovered during the review. Recently, the OIG checked in on a previously audited medical supply company to determine whether it implemented changes that would bring it into compliance with state and federal laws, policies and rules.

In November 2020, the OIG issued an audit for durable medical equipment supplier Maverick Medical Supply. The scope included paid fee-for-service claims between September 2017 and August 2019 and reviewed relevant activities, internal controls and information technology controls through October 2020. The original audit showed that Maverick complied with recording and documentation guidelines for deliveries in 1,750 of 1,858 tested claims. The remaining claims were missing proof of delivery documents, resulting in an overpayment of $11,735.

The follow-up audit determined that the medical equipment supplier had returned all overages and fully implemented provided audit recommendations. By following through with auditor recommendations the provider did not receive a reissuance of any previous recommendations. According to auditors, Maverick now retained the required documentation for submitted claims.

The OIG provided Maverick with six recommendations based on the initial audit. Maverick addressed all six by:

• Implementing controls to ensure that products are delivered and Medicaid fee-for-service durable medical equipment and supplies claims are submitted only when the patient has a current, complete and valid Home Health Services DME/Medical Supplies Physicians Order Form.
• Strengthening controls to ensure that quantities delivered do not exceed authorized amounts.
• Ensuring that they have a current, complete and valid Title XIX form prior to delivering products and submitting claims.
• Implementing controls to ensure the Title XIX form includes a date for the last time the physician saw the client and that this date is within the proper window for product coverage.
• Submitting claims only after receiving itemized invoices from third-party suppliers and independent confirmation and tracking details from subcontracted delivery services.
• Returning $11,735 in overpayments that resulted from the issues found during the audit.