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OIG Slams Medicare for Wheelchair Reimbursements, Again

Cheryl Clark, for HealthLeaders Media, July 8, 2011

The OIG report found that, after reviewing prescribing physicians records, those records did not support the medical necessity of those wheelchairs.

The agency's report said that despite numerous reviews of expenditures for these medical devices, "Medicare has paid significantly more in recent years (since 2007) for power wheelchairs than it did in 2007...(indicating) that CMS (the Centers for Medicare & Medicaid Services) continues to pay for power wheelchairs that are not medically necessary and/or that have claims that do not meet documentation requirements."

Two previous OIG reports found these and other problems with coding and documentation.

The OIG recommends that CMS:

1.     Enhance reenrollment screening standards for durable medical equipment prosthetics, orthotics and supplies (DEMPOS) benefits

2.     Review records from sources in addition to the supplier, such as records from the prescribing physician, to determine whether power wheelchairs are medically necessary.

3.     Continue to educate power wheelchair suppliers and prescribing physicians to ensure compliance with clinical coverage criteria.

4.     Review suppliers of sampled claims that were found to be in error.

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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.