OIG audits Marquis Mobility

Provider says he's first in new national program
Friday, May 25, 2012

CANTON, Ohio – The Office of Inspector General (OIG) has begun to take a closer look at individual providers of power mobility devices.

The OIG released a report this month that states 43 of the 200 power wheelchair claims submitted by Marquis Mobility from 2006-09 didn't meet Medicare requirements. As such, it recommends the provider refund $680,024 and “enhance controls” to make sure future claims meet Medicare requirements.

"In the event that we'll have to fight, we'll win," said Rick Worstell, owner of Marquis Mobility, who says his record includes a 100% approval rate in a prepay audit last year.

It’s now up to Medicare to ask for a refund and, if it does, Marquis Mobility would appeal “vehemently,” says Worstell, who also founded The Audit Team, which provides audit-related services to providers.

Marquis Mobility is just the first of many power mobility providers that the OIG plans to audit, Worstell says. It was chosen, he says, because of its high claims volume.

"It was our understanding that it was simply a roll-out of a national program that they were going to start auditing power wheelchair companies," Worstell said.

An OIG spokesman told HME News that he couldn’t speak specifically about the Marquis Mobility audit. He did confirm, however, that part of the OIG's 2012 Work Plan is to review Medicare Part B payments to power mobility devices and other DME.

Any audits of power mobility devices in 2006, when providers were confused by and having difficulty complying with a new face-to-face requirement, probably aren’t going to turn out well. Worstell says 41 of the 43 claims that the OIG says are in error were submitted within six months of that change.

"If you go back to that timeframe, anyone who's been in the business will tell you it was chaos," he said. 

Marquis Mobility has 30 days to respond to the OIG report.

"Whether Medicare is going to seek a return of all or a portion of those monies is up to them," said Stephanie Morgan Greene, general counsel for The Audit Team. "There is no definitive timeline for them to make that decision."