Briefs: Parents sue Medicaid over wheelchair denial

Monday, April 25, 2011

TYLER, Texas - The parents of a child with cerebral palsy filed a lawsuit in March against the Texas Health and Human Services Commission for denying their child a power wheelchair, according to The Southeast Texas Record. The parents claim the 4-year-old child is an eligible beneficiary entitled to all medically necessary services, including DME, under Medicaid's Early and Periodic Screening, Diagnosis and Treatment program. "As a result of (the child's disabilities) and health conditions, he cannot crawl, stand or ambulate independently, and he cannot self-propel a manual wheelchair," the lawsuit states. 

High denial rate in Jurisdiction A

HINGHAM, Mass. - Power wheelchair claims from October 2010 to December 2010 had a 61% denial rate in Jurisdiction A, according to the results of a probe review released by the NHIC in March. That's down from a 62.6% denial rate for July 2010 through September 2010. In its most recent probe, the NHIC, the DME MAC for Jurisdiction A, reviewed 779 claims for K0823s submitted by 251 suppliers. Responses to its additional documentation requests were not received for 213 claims. The primary reason for denials was lack of clinical documentation to justify medical necessity (60%). Based on the results of the probe, NHIC will continue to review claims billed for K0823.

Firm recognizes The Scooter Store

NEW BRAUNFELS, Texas - Runzheimer International recognized The Scooter Store in March for using best practices and formal measurement to manage costs and strengthen employee satisfaction, cost management and customer service. Ruzheimer, a provider of employee mobility programs, recognized The Scooter Store for transitioning, over the past two years, 229 of its 500 vehicles to more fuel efficient vehicles, resulting in annual savings of $700,000.

Short takes: VMI

Vantage Mobility International (VMI) announced in April that the redesigned 2011 Honda Odyssey with VMI Northstar and Summit van conversations are available for sale. The vans are available in four trim levels: EX, EX-L, Touring and Touring Elite...VMI also announced in April that it's the exclusive dealer of the Fiorella Platform Lift in the United States.