On January 13, 2010, the Office of Inspector General (“OIG”) revised and reissued its 2003 Special Fraud Alert regarding prohibited telemarketing conduct by durable medical equipment (“DME”) suppliers. There is a new twist.
Both the previous and new OIG Special Fraud Alert explains that DME suppliers are statutorily prohibited from making unsolicited telephone calls to Medicare beneficiaries regarding the furnishing of a Medicare covered item, except in certain limited circumstances. The OIG explained that the statute also prohibits payment to a supplier who “knowingly” submits a claim generated pursuant to a prohibited telephone solicitation and that such claims are false. Consequently, violators are potentially subject to criminal, civil and administrative penalties, including exclusion from the Federal health care programs.