Most Wheelchair Claims Do Not Meet Medicare Requirements

By Author: Jaun Paul
Total Articles: 53
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The HHS Office of Inspector General just turned the heat on durable medical equipment (DME) suppliers. According to a new report, three out of the five 2007 wheelchair claims the OIG inspected did not meet the Medicare documentation requirements. The OIG says that two out of five claims had multiple errors per claim.


Of the $189 million the Centers for Medicare & Medicaid Services and Medicare beneficiaries paid for power wheelchairs in a six-month period during that year, $112 million was improper owing to faulty documentation.


The OIG found out that the biggest offenders were complex rehab power wheelchairs, with a higher documentation error rate as well as standard power wheelchairs submitted by low-volume suppliers.


One of the documents complex rehabilitation power wheelchair suppliers most often do not submit is the specialty evaluation report. The OIG wants CMS to improve compliance with Medicare's wheelchair documentation ...
... requirements by conducting more review of wheelchair claims, recovering overpayments, taking action against suppliers who do not meet documentation requirements, and improving education.


But the American Association for Homecare insists that the authorities should not be pointing a finger at suppliers for this problem. It maintains that the regulatory documentation requirements are confusing, onerous, and must be improved.


The OIG study does not illustrate a problem with provider compliance but instead reflects the obstacles providers face with Medicare documentation and its paperwork requirements.

Provides weekly digest newswire about Medicare documentation, and offers advanced Learning Opportunities Medicare requirements according to 2010 OIG Work Plan.