CMS keeps tabs on Harris County

Monday, April 30, 2007

HOUSTON - CMS has come a long way in reducing power wheelchair fraud in Harris County, Texas, since it launched Operation Wheeler Dealer in 2002, regional officials say. But the three-year investigation may have had unintended consequences.
As a result of the investigation, the number of submitted charges for PWCs dropped to $20,150,712 in 2006 from $154,774,372 in 2002 and the number of beneficiaries billed dropped to 3,354 in 2006 from 21,353 in 2002, according to recently released data from CMS's regional office in Dallas. Additionally, 355 supplier numbers have been revoked.
Officials don't have current claims data. Just before the investigation launched, however, the number of PWC claims skyrocketed to 31,000 in 2002 from 3,000 in 2001, they say.
"We consider Operation Wheeler Dealer a success," said Tony Salters, a CMS spokesman in Dallas. "But it's ongoing. We're still monitoring wheelchair activities on a regular basis."
While they welcome CMS rooting out fraud, providers like The Scooter Store believe Operation Wheeler Dealer may have also spooked legitimate physicians, reducing access to PWCs.
"Every time there's an indictment filed, it resurrects this feeling of worry among physicians about prescribing power wheelchairs," said Mark Leita, director of public affairs for The Scooter Store. "A lot of them choose to forgo any risks by not prescribing them at all."
The Scooter Store hosted two seminars last year to help educate physicians on wheelchair coverage and policies, as well as how to tell if a provider is above-board (One indicator, says Leita: accreditation).
At least one provider isn't so sure unscrupulous providers aren't looking to do business in Harris County again.
"We've been getting calls from companies asking us about things that are not reasonable," said the provider. "They'll say, 'We're a new dealer, but we don't want to deal with this or that; can we send those clients to you?' I'm suspicious we're getting a surge."