CMS goes by the numbers

Friday, April 30, 2004

WASHINGTON - When it comes to Medicare reimbursement for wheelchairs, CMS officials presented some eye-popping numbers at the March 31 forum.

In what Kim Brandt, acting director of the Program Integrity Group, called a “significant increase,” Medicare payments for power wheelchairs increased from about $10 million in 1994 to more than $1.2 billion in 2003. More troubling, she added, is the 300% increase in spending for wheelchairs between 2001 and 2003. By comparison, Medicare’s overall spending during that period increased only 11%, she said.

Medicare officials attribute that increase to a number of things: fraud, new technology, and also to a lax interpretation by the DMERCs of the bed- or chair-confined criteria.

In Harris County, Texas, where the Wheeler Dealer scandal erupted last fall, submitted charges for K0011 power wheelchairs have dropped from $59 million in May 2003 to $5 million in March 2004 thanks to enforcement efforts, said Steve McAdoo, an associate regional administrator in CMS’s Dallas regional office.