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OIG Slams Medicare for Wheelchair Reimbursements, Again

Cheryl Clark, for HealthLeaders Media, July 8, 2011

In a letter responding to the report, CMS administrator Don Berwick said he agreed with the second, third and fourth recommendations, but not the first.

"CMS has in place other tools that allow for increased scrutiny of existing DMEPOS suppliers – particularly new authorities provided to us under the Affordable Care Act," he wrote. "In addition, CMS can impose a payment suspension against an existing provider or supplier in cases where it has been determined...that there is a credible allegation of fraud against the provider or supplier."

Federal fraud investigators have targeted Medicare's unnecessary wheelchair reimbursements for more than a decade. Between 1999 and 2003, Medicare's bill for power wheelchairs shot up 350% to $1.2 billion a year, more than 12 times overall Medicare program expenditure increases. This prompted CMS to revise its power wheelchair coverage and coding in 2005 and 2006, and costs subsequently decreased to $658 million in 2007.

Now, costs are rapidly rising again, to $779 million in 2008 and to $728 million in 2009.

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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.