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Seven durable medical equipment companies cost the Medicare system $2 billion in payments, the National Association of ACOs (NAACOS) told the federal government in recent months. But it’s unclear just how problematic that will be for accountable care organizations.
The association’s allegations come from a review of two billing codes for Medicare claims data from the Centers for Medicare & Medicaid Services (CMS) Virtual Research Data Center. They say urinary catheter payments to beneficiaries accounted for $153 million in 2021 before surging to $2.1 billion in 2023. Catheter spending by DMEs increased by 15.5% as false claims were filed around the country.
These payments could financially impact ACOs, potentially cutting into the groups’ hard-earned savings and affecting benchmarking calculations for future years.