Court: CMS can request info beyond CMN

Sunday, December 31, 2006

ATLANTA - A U.S. Court of Appeals sided with CMS in mid-November in a dispute over whether the agency had the right to request power wheelchair documentation beyond CMNs from Gulfcoast Medical.
The 11th Circuit Court's Nov. 3 decision is significant because the court has jurisdiction over three states: Georgia, Florida and Alabama.
"When a circuit court makes a ruling, it's the law of the land in those states," said Jeff Baird, a healthcare attorney with Brown & Fortunato.
Additionally, three courts have now made the same decision. Previously, a federal district court in Florida sided with CMS over Gulfcoast Medical. In March, another district court sided with the agency over Mackenzie Medical in a similar case.
But one case is still outstanding. In 2005, a federal district court sided with Maximum Comfort, saying CMS wrongly demanded the provider repay $600,000 for not supply additional documentation. CMS appealed the decision, sending the case to the 9th Circuit Court. The two parites still await a court date. If there's another appeal, the case would move to the U.S. Supreme Court.
Despite the Gulfcoast decision, Tom Lambert, president of Maximum Comfort, isn't disheartened.
"Their argument was that CMS had no right to ask for anything outside the CMN," he said. "Our argument is that CMS is barking up the wrong tree."