Department of Health and Human Services

Office of Inspector General -- AUDIT

"South Carolina Medicaid Durable Medical Equipment Provider Enrollment Practices From March 21, 1995, Through June 30, 2005," (A-04-05-04010)

November 26, 2007


PDF File Complete Text of Report is available in PDF format (1.19 mb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Our objective was to determine whether the State agency allowed durable medical equipment (DME) suppliers to remain in the Medicaid program after their Medicare supplier numbers had been revoked.  The State agency took no action against eight suppliers who violated Federal standards and had their Medicare numbers revoked.  Of the eight suppliers that we identified, the State agency paid $2,084,390 (Federal share $1,459,073) to four suppliers after their Medicare supplier numbers were revoked.  The other four suppliers had not billed for any DME, even though they maintained active Medicaid supplier numbers.

We recommended the State agency revise the DME enrollment and renewal process to include verifying the validity of an applicant’s Medicare DME supplier number and consider suspending or terminating Medicaid DME suppliers who have had their Medicare supplier numbers revoked.  The State said that it would take our findings and recommendations under advisement.