OIG to Hoveround: Pay back $27 million

Friday, December 4, 2015

WASHINGTON – The Office of Inspector General (OIG) wants Hoveround to pay back the federal government $27 million for power mobility devices that it says do not meet Medicare reimbursement requirements.

The OIG audited claims for 200 randomly selected beneficiaries who received PMDs from the direct-to-consumer manufacturer in 2010 and found 154 did not meet Medicare requirements. Of those, 144 did not meet medical necessity requirements and 10 had incomplete documentation, according to the agency’s report.

On the basis of its sample, the OIG estimates that Medicare paid Hoveround more than $27 million for PMDs that did not meet requirements in 2010. In all, Hoveround received nearly $50 million for PMDs that year, the second-largest reimbursement for these claims.

In addition to the refund, the OIG recommends that Hoveround implement internal controls to ensure that beneficiaries meet requirements before providing equipment.

In a written response to the report, Hoveround disagreed with the findings, saying the OIG applied incorrect standards, and the agency influenced the medical review and biased the results. Furthermore, Hoveround claims the OIG never revealed it was conducting a medical necessity review and therefore the company was unable to submit supporting evidence.

The OIG denies Hoveround’s allegations and stands by the review’s findings.