Buck doesn't stop at CMN, court says

Sunday, April 30, 2006

BALTIMORE - Medicare has the right to require documentation beyond the CMN for power wheelchair claims, a U.S. district court ruled March 14. For years, Mackenzie Medical has fought Medicare's request that it repay more than $500,000 in reimbursement for 135 disputed wheelchair claims. The provider has argued that "Congress unambiguously intended that suppliers be required to submit only a CMN," according to the ruling. The court, however, disagreed, stating that "if the secretary were only able to look to the CMN to determine medical necessity, the secretary could never deny a claim when the physician had written a prescription."