I 
113TH CONGRESS 
2D SESSION 
H. R. 5083 
To amend title XVIII of the Social Security Act to improve audit effectiveness 
and efficiency in paying for durable medical equipment, prosthetics, 
orthotics, and supplies (DMEPOS) under the Medicare program, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 11, 2014 
Mrs. ELLMERS (for herself, Mr. BARROW of Georgia, Mr. BRALEY of Iowa, 
Mr. DUNCAN of Tennessee, and Mr. THOMPSON of Pennsylvania) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committee on Ways and Means, 
for a period to be subsequently determined by the Speaker, in each case 
for consideration of such provisions as fall within the jurisdiction of the 
committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to improve 
audit effectiveness and efficiency in paying for durable 
medical equipment, prosthetics, orthotics, and supplies 
(DMEPOS) under the Medicare program, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare DMEPOS 
Audit Improvement and Reform (AIR) Act of 2014’’. 
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SEC. 2. IMPROVING MEDICARE AUDIT EFFECTIVENESS AND 
EFFICIENCY FOR DURABLE MEDICAL EQUIP-
MENT, PROSTHETICS, ORTHOTICS, AND SUP-
PLIES (DMEPOS). 
(a) MEDICARE ADMINISTRATIVE CONTRACTOR PAY-
MENT
OUTREACH
AND
EDUCATION
PROGRAM
FOR 
DMEPOS SUPPLIERS.— 
(1) IN GENERAL.—Section 1874A of the Social 
Security Act (42 U.S.C. 1395kk–1) is amended— 
(A) in subsection (a)(4)— 
(i) by redesignating subparagraph (G) 
as subparagraph (H); and 
(ii) by inserting after subparagraph 
(F) the following new subparagraph: 
‘‘(G) PAYMENT
OUTREACH
AND
EDU-
CATION PROGRAM FOR SUPPLIERS OF DURABLE 
MEDICAL
EQUIPMENT, 
PROSTHETICS, 
ORTHOTICS, AND SUPPLIES (DMEPOS).—Imple-
menting a payment outreach and education pro-
gram for DMEPOS suppliers under subsection 
(h).’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(h) PAYMENT OUTREACH AND EDUCATION PRO-
GRAM FOR DMEPOS SUPPLIERS.— 
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‘‘(1) IN
GENERAL.—In order to reduce im-
proper payments under part B for durable medical 
equipment, prosthetics, orthotics, and supplies, each 
medicare administrative contractor that has respon-
sibility for payment under such part for durable 
medical equipment, prosthetics, orthotics, and sup-
plies furnished in an area (in this subsection re-
ferred to as a ‘Medicare DMEPOS contractor’) shall 
carry out a program (in this subsection referred to 
as the ‘DMEPOS payment outreach and education 
program’) under which the contractor, through out-
reach, education, training, and technical assistance 
activities conducted on a quarterly basis, provides 
DMEPOS suppliers, physicians and practitioners 
who prescribe DMEPOS, and discharge planners 
and case managers who coordinate DMEPOS for in-
dividuals in such area with the information described 
in paragraph (3) and with error reduction training 
under paragraph (4). 
‘‘(2) FORMS
OF
ACTIVITIES.—The activities 
under a DMEPOS payment outreach and education 
program shall include the following: 
‘‘(A) Emails and other electronic commu-
nications. 
‘‘(B) Webinars. 
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‘‘(C) Telephone calls. 
‘‘(D) In-person training. 
‘‘(E) Other forms of communications and 
assistance determined appropriate by the Sec-
retary. 
‘‘(3) INFORMATION TO BE PROVIDED THROUGH 
ACTIVITIES.—The information to be provided under 
a DMEPOS payment outreach and education pro-
gram, with respect to payment for DMEPOS under 
part B, shall include all of the following information: 
‘‘(A) A list of suppliers’ most frequent pay-
ment errors and most expensive payment errors 
over the last quarter. 
‘‘(B) Specific instructions regarding how to 
correct or avoid such errors in the future. 
‘‘(C) A notice of all new topics that have 
been approved by the Secretary for audits con-
ducted by Medicare contractors in relation to 
payment for DMEPOS under part B. 
‘‘(D) Specific instructions to prevent fu-
ture issues related to such new audits. 
‘‘(E) Other information determined appro-
priate by the Secretary. 
‘‘(4) ERROR RATE REDUCTION TRAINING.— 
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‘‘(A) IN GENERAL.—The activities under a 
DMEPOS payment outreach and education pro-
gram shall include error rate reduction training. 
‘‘(B) 
REQUIREMENTS.—Such 
training 
shall— 
‘‘(i) be provided at least annually; and 
‘‘(ii) focus on reducing improper 
Medicare payments for DMEPOS. 
‘‘(C) INVITATION.—A Medicare DMEPOS 
contractor with responsibility for payment for 
DMEPOS in an area shall ensure that all 
DMEPOS suppliers, physicians and practi-
tioners who prescribe DMEPOS, and discharge 
planners and case managers who coordinate 
DMEPOS for individuals in the area are invited 
to attend the training described in subpara-
graph (A) either in person or online. 
‘‘(5) PRIORITY.—A Medicare DMEPOS con-
tractor shall give priority to activities under the 
DMEPOS payment outreach and education program 
that will reduce improper Medicare payments based 
on technical errors, medical necessity, and fraud for 
DMEPOS that— 
‘‘(A) have the highest rate of improper 
payment under part B; 
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