OIG Slams Medicare for Wheelchair Reimbursements, Again
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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