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Payment Credits for Replaced Medical Devices That Were Implanted

Certain medical devices are implanted during an inpatient or outpatient procedure. Such devices may require replacement because of defects, recalls, mechanical complication, etc. Federal regulations require reductions in Medicare payments for the replacement of implanted devices that are due to recalls or failures (42 CFR §§ 412.89 and 419.45). Prior OIG reviews have determined that Medicare Administrative Contractors made improper payments to hospitals for inpatient and outpatient claims for replaced medical devices. We will determine whether Medicare payments for replaced medical devices were made in accordance with Medicare requirements.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
October 2017 Centers for Medicare & Medicaid Services Payment Credits for Replaced Medical Devices That Were Implanted Office of Audit Services W-00-16-35745; various reviews 2018

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