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OIG Fraud Alert to DME Suppliers on Telemarketing Prohibition

On January 13, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a special fraud alert to remind durable medical equipment (DME) suppliers that unsolicited telephone calls to Medicare beneficiaries are prohibited by federal law. The fraud alert referred specifically to instances in which independent marketing firms make unsolicited contact with Medicare beneficiaries to market the DME supplier.

The Social Security Act prohibits such unsolicited contact by a DME supplier, except in three specific situations:

(1) when the beneficiary has given express written permission to the supplier to contact him or her by phone;

(2) the contact is about a covered item that the supplier already has furnished to the beneficiary; or

(3) the supplier has furnished at least one covered item to the beneficiary during the preceding 15 months.

The Social Security Act also states that payments are prohibited to a supplier that knowingly submits a claim produced by unsolicited contact with a Medicare beneficiary. Any such payments are considered false and could subject the violator to criminal, civil and administrative penalties.

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