Home Health & Hospice Week

POV restriction on fast track for elimination due to power wheelchair crackdown.

Mobility product suppliers may see a change in physicians' prescription patterns when a planned Medicare rule takes effect. The Centers for Medicare & Medicaid Services plans to issue a final rule in February that would allow all physicians to prescribe power-operated vehicles, commonly known as scooters. Currently, only certain physician specialties can prescribe POVs, attorney Cara Bachenheimer, government relations vice president for Elyria, OH-based Invacare Corp., tells Eli. On the other hand, any physician can order a power wheelchair under Medicare rules, notes attorney Timothy Webster with Amarillo, TX-based Brown & Fortunato. "POVs are less expensive than power wheelchairs, and the Medicare program would save money if more beneficiaries received POVs instead of power chairs," Webster says of CMS' rationale for the rule.   "POVs are less expensive than power wheelchairs, and the Medicare program would save money if more beneficiaries received POVs instead of power chairs," attorney Timothy Webster says of CMS' rationale for the rule.   Suppliers will see this change take place quickly because it was implemented as part of Operation Wheeler Dealer, the feds' crackdown on fraud and abuse of power wheelchairs under Medicare (see Eli's HCW, Vol. XII, No. 32, p. 251). The rule "is on the fast track for publication," Webster points out. "According to the regulatory agenda, it will be published as a final rule with comment period, bypassing the proposed rule stage." Under the seventh point in the feds' 10-point fraud-fighting plan, CMS vowed to issue final regulations allowing all physicians to prescribe POVs. In that same point, the agency also pledged that the rule would require for the first time that physicians see a patient before prescribing a wheelchair or scooter. CMS mentions no specifics in the agenda, but does note the forthcoming rule would "make the requirements to purchase [POVs], functioning as wheelchairs, less stringent." That may indicate the requirement to see patients first will make its appearance elsewhere. Other durable medical equipment-related items in the agenda include: Supplier standards. CMS plans to propose a rule in August requiring certain standards for suppliers of home oxygen, therapeutic shoes for diabetics and home nutrition therapy. This rule has been delayed for years, Webster notes, and is likely to be delayed again. The dates in the agenda are "only estimates," Bachenheimer reminds suppliers. They "often get pushed back given CMS' workload."

Clarifying the standards for diabetic shoes especially would be helpful, Webster says. DME regional carrier medical policy "currently provides that diabetic shoes must be fitted and furnished by a podiatrist 'or other qualified individual,'" Webster points out. "It has never been clear exactly who is a 'qualified individual.'" Billing privileges appeals. [...]