Major media coverage of DME fraud continued this week with a New York Times article devoted to what amounts to an internal dispute between federal inspectors and Medicare officials. According to the Times article this week from reporter Charles Duhigg, the findings of a federal inspector general’s confidential report essentially accuse Medicare officials of overstating their success in 2006 when officials claimed to have prevented billions in fraudulent payouts.

Some lawmakers and Congressional staff members say the irregularities raise new questions about the credibility of other Medicare figures. “This is outrageous,” said Senator Charles E. Grassley (R-Iowa), in the article. As the top-ranking Republican on the Senate Finance Committee, Duhigg points out that Grassley has repeatedly credited CMS with reducing improper expenditures. “If heads don’t roll, you can’t change the culture of this organization,” added Grassley.

Reports on the internal feud eventually give way to a rehashing of DME fraud and abuse, with no industry representative quoted. “Fraudulent and improper payments have long bedeviled Medicare, a $466 billion program. In particular, payments for durable medical equipment, like power wheelchairs and diabetic test kits, are ripe for fraud,” writes Duhigg. “On July 1, Medicare instituted a new competitive bidding system that officials said would reduce both fraud and costs for medical equipment. On July 15, however, Congress suspended the program, after equipment manufacturers and sellers began an aggressive lobbying campaign.”

Frequent CMS critic Rep Pete Stark (D-Calif) is also quoted by Duhigg, saying: “This report doesn’t surprise me. To look better to the public, you cook the books…This agency is incompetent.”

Perhaps the most damaging (and unanswered) quote comes at the end of the article: “This is like letting the fox guard the henhouse,” said Malcolm Sparrow, a Harvard University professor who focuses on health care fraud. “The supplier has an incentive to supply fabricated documents or to imply that medical records support a purchase when they don’t. If you don’t ask the physician or ask for medical records, you can’t really verify anything.”

In response to the article, the VGM Group sent a letter to members encouraging them to contact Congressional members and voice concerns about CMS’ incompetence. “The OIG report finds incompetence or fraud in the Medicare program,” write VGM officials, “but point the finger at DME.” VGM believes providers should let legislators know that they: 1) want to weed out fraudulent providers; 2) support accreditation to eliminate bad apples; and 3) believe CMS’ incompetence should be factored into the overall equation.