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OIG Slams Medicare for Wheelchair Reimbursements, Again

Cheryl Clark, for HealthLeaders Media, July 8, 2011

Medicare paid $95 million during the first half of 2007 for beneficiaries' power wheelchairs that were not medically necessary or for which claims lacked sufficient documentation, according to an audit released Thursday by the Office of Inspector General. 

The $95 million was 61% of the $189 million that the agency allowed for power wheelchairs – which cost between $4,132 to $11,965 – in the first half of 2007.

"Based on records submitted by suppliers that provided power wheelchairs, 9% of power wheelchairs were medially unnecessary and another 52% had claims that were insufficiently documented to determine whether the power wheelchairs were medically necessary," the OIG said.

For some of these beneficiaries, a less expensive type of equipment or a different type of power wheelchair would have sufficed.

By definition, power wheelchairs are approved for Medicare beneficiaries whose "mobility deficit cannot be addressed using other types of mobility-assistive equipment, such as a cane, manual wheelchair or scooter," the OIG report said.

Additionally, the beneficiary must be physically and mentally able to operate a power wheelchair and that person's home must provide adequate access between rooms for the wheelchair to operate. To qualify for more specific types of power wheelchairs, the beneficiary must satisfy other criteria. For example, his or her weight must be equal to the capacity of the power wheelchair.

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2 comments on "OIG Slams Medicare for Wheelchair Reimbursements, Again"


Prafull Shah (7/8/2011 at 3:33 PM)
With scooter and wheelchair hawkers on TV , e-mail and other media, showing scooter-bound persons practically "dancing" in their wheelchair tauting "and it didn't cost me a dime", what would you expect? These are the most outrageous and boldest advertisements for items that are meant to be "required" for medical reasons, not for joyrides! I am glad that Feds are now capturing these bandits. Should have happened long time ago. In the mean time, many such con-artists have become millionaires.

Prafull S. (7/8/2011 at 12:33 PM)
Just the propensity of scooters and powerchairs suppliers to have massive budget for TV and e-mail media blitz uabashingly advertizing that it will "Not cost you a dime", and the ever-growing number of such hawkers should alert anyone that this must be a very lucrative business to be in.