OIG to Medicare: Adjust allowables for orthotic devices
By HME News Staff
Updated 8:41 AM CDT, Mon October 21, 2024
WASHINGTON – The Office of Inspector General has included on its “Top Unimplemented Recommendations” list a recommendation that Medicare review Medicare allowable amounts for 161 orthotic device HCPCS codes that it says the agency and its beneficiaries have paid an estimated $337.5 million more for than select non-Medicare payers. The OIG also recommends that Medicare adjust the allowable amounts, as appropriate, using regulations promulgated under existing legislative authority or if the allowable amounts cannot be adjusted using regulations in that way, seek legislative authority to align Medicare allowable amounts for these items with payments made by select non-Medicare payers. The OIG first made this recommendation in October 2019. Read its report on the issue here.
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