Home Health & Hospice Week

Power wheelchairs add up to a powerful compliance problem for suppliers.

Recent crack-downs on Medicare fraud schemes built around power wheelchairs show the feds are still watching claims for those items closely. Durable medical equipment suppliers should make sure their power wheelchair claims are carefully documented and in compliance with all Medicare rules, warn experts.

Two DME company operators and five others were indicted on criminal charges Feb. 21 in connection with a multi-million dollar Medicare billing scheme, reports U.S. Attorney Marcos Jimnez. Prosecutors say Chadd Miller and Todd Neff, who owned or controlled Imagine Consulting Services and K&F Services Corp., had patient recruiters pay kickbacks to Medicare patients for agreeing to act as bogus power wheelchair recipients.

The recruiters then allegedly orchestrated "staged deliveries" during which they'd have the patients sign "delivery confirmation tickets," take pictures of them sitting in the wheelchairs to verify the delivery, then come back later to pick up the chairs for use in other staged deliveries.

Meanwhile, Miller, Neff and the recruiters allegedly forged certificates of medical necessity and used the photos, tickets and CMNs to try to support more than $5 million in power wheelchair-related Medicare claims.

In another recent case, a Northville, MI man faces up to 20 years in prison and a $250,000 fine after a jury convicted him of health care fraud, kickbacks and other charges. According to U.S. Attorney Jeffrey Collins, HusseinAmr, owner and president of United States Medical Supply in Livo-nia, MI, will also have to forfeit more than $1 million of what the feds say were ill-gotten gains.

The case centered on power wheelchairs, and the specific charges read like a laundry list of DME compliance no-nos. Amr was accused of billing standard equipment - such as wheels - as extra-cost options, billing for more expensive cushions than he actually supplied, inflating labor hours on repair claims and offering kickbacks to generate business.

And the Department of Justice has won an order freezing the assets of Chula Vista, CA supplier Benison Medical Supply Inc. based on allegations that it falsified medical necessity documents, U.S. Attorney Carol Lam says.

Lam says her office has filed a civil complaint against Benison and its owner, Renato Paulin, accusing the two of trumping up bogus documents for Medicare and Medi-Cal claims since 1997. They're also accused of billing for equipment that was never supplied.

Power wheelchairs and hospital beds were the supplies at issue in the case, which the government maintains cost Medicare and Medi-Cal more than $1 million.