Home Health & Hospice Week

While the Government Accountability Office gives suppliers a small break in its report, assaults on the industry continue from other quarters.
 
"Scams" and "waste ... riddle [Medicare's] power wheelchair program," insists Sen. Charles Grassley (R-IA) in a release. "With power wheelchairs, the greedy are too often taking what should go to the needy," said Grassley, who commissioned the GAO report.
 
Further, Senate Finance Chair Grassley calls on CMS "to curb the rapid rise in spending for power wheelchairs" and accuses suppliers of "misleading marketing practices."
 
The HHS Office of Inspector General also showcases wheelchair fraud in its latest semiannual report released in December. "Examples presented in this semiannual report include significant investigations of fraud in the durable medical equipment industry, particularly power wheelchairs," the OIG says in its introduction.
 
In fact, all three DME examples involve wheelchair fraud. Inglis Durable Medical Equipment Company Inc. and two unnamed suppliers from Florida and Texas paid hundreds of thousands of dollars in restitution, faced jail time and undertook corporate integrity agreements for wheelchair-related misdeeds.
 
And the OIG rehashes its reports saying only 13 percent of K0011 claims sampled were valid and Medicare overpaid for wheelchairs by $224 million in 2002 (see Eli's HCW, Vol. XIII, No. 17, p. 132).

CMS Fires Shot

Finally, the Centers for Medicare & Medicaid Services says "Medicare spending for power wheelchairs and power scooters has skyrocketed in recent years" in its recent press release announcing the wheelchair coverage criteria National Coverage Determination.
 
Erik Sokol with the Power Mobility Coalition counters that assertion, noting in a release that recent data from the Statistical Analysis DME Regional Carrier indicate "Medicare has already restricted access to power wheelchairs by one third."
 
Legitimate factors have contributed to growth in the Medicare power wheelchair benefit, including technologies allowing power chairs to be used primarily in the home, the increase in the aging population, and an increase in awareness of the power mobility benefit, Sokol insists.
 
And mobility devices save Medicare money by keeping beneficiaries out of costly institutions, he notes.
 
Wheelchair dealers have been painted with a broad fraud brush, and are seeing the consequences in reduced payments, increased claims scrutiny and increased denials. Suppliers are fighting to "de-link" the notion of fraud and power mobility, Sokol tells Eli. 
 
Editor's Note: The OIG report is at www.oig.hhs.gov/publications/semiannual.html.