Monday, May 31, 2004

Investigators key in on 155 potential schemes

WASHINGTON - The DMERCs have referred 155 potential cases of power wheelchair fraud to law enforcement since the eruption of the Wheeler Dealer scandal in Houston last September, according to CMS testimony at the Senate Finance Committee hearing April 28. About 10% of these cases have been closed already, and federal officials have recovered about $84 million in fraudulent claims since that time. The DMERCs also are looking into an additional 77 cases to determine whether they should turn over those investigations to law enforcement. Beyond that, the DMERCs are prepared to review 196 cases for evidence of fraudulent activity.
CMS to weigh in on proposed PWC codes

WASHINGTON - Industry watchers expected CMS to issue preliminary recommendations late last month on proposed new coding for power wheelchairs. Public meetings regarding the recommendations are scheduled for June 28-30 at CMS in Baltimore. The National Coalition for Assistive Rehab Technology (NCART) submitted six new codes to replace existing PWC coding. The new codes are the same ones submitted to CMS in March 2003 under the auspices of AAHomecare’s Rehab and Assistive Technology Council. The suggested codes more accurately reflect the patient’s clinical needs and the equipment’s technical specifications, NCART wrote in a position paper.
RAMP report takes issue with government findings

WASHINGTON - In response to a flood of government reports on the K0011, the Restore Access to Mobility Partnership (RAMP) issued its own report outlining the distortions and flaws of the government findings. RAMP takes issue with comparisons of Medicare and the VA in regards to payments for power wheelchairs. A second issue is that RAMP believes pricing data was compiled from too small a sample that was “hardly valid to make any sweeping declarations about pricing.” Only eight suppliers and 36 transactions were reviewed for the findings. The RAMP report did commend the development of new codes for mobility products, calling it a “crucial step in the right direction.”