Medicare Payments to Suppliers for Oxygen and Oxygen Equipment

OBJECTIVE

Medicare covers reasonable and necessary durable medical equipment, prosthetics, and orthotics supplies, such as oxygen and oxygen equipment (Social Security Act §§ 1861(n), (s)(6), (8), and (9) and § 1862 (a)(1)(A)). For calendar year 2023, Medicare paid more than $674 million for oxygen and oxygen equipment. CMS has consistently identified high rates of improper payment for oxygen and oxygen equipment through its Comprehensive Error Rate Testing program. Upon request, a supplier must provide documentation, including records from the treating practitioner, indicating that oxygen and oxygen equipment were reasonable and necessary for an enrollee’s condition (42 CFR § 410.38(d)(3)). We will determine whether Medicare paid suppliers for oxygen and oxygen equipment according to Medicare requirements.

TIMELINE

• October 15, 2024
  Announced
• Today
  Office of Audit Services In-Progress
• Est FY2026
  Estimated Fiscal Year for Project Completion

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