Friday, October 31, 2003

Wheeler Dealer concerns
with Kay Cox

Q. What effect will CMS’ “Wheeler Dealer” initiative have on DME providers?

A. CMS launched their new 10-point plan in response to a Houston-based wheelchair scam that involved unscrupulous doctors and providers working together to secure and bill Medicare for power wheelchairs that either were never delivered or substituted with a less expensive model. This scam cost taxpayers millions of dollars, and AAHomecare and DME providers applauded CMS for taking action to prevent these types of fraudulent activities from occurring in the future. But, because CMS’ new initiative is untested, we need to be diligent in alerting CMS to our concerns and monitoring the effect that it has on the vast majority of law abiding DME providers.

What overall impact will CMS’ 10-point initiative have on DME providers? It’s hard to say at this point, but AAHomecare is concerned that the initiative could unfairly penalize responsible DME providers who adhere to Medicare regulations, especially if CMS institutes an across the board payment reduction. In addition, CMS may implement more safeguards on power wheelchair utilization, such as modifying coverage criteria, increasing audits and site visits, and/or more strictly scrutinizing claims and new suppliers. One thing that is for certain is that AAHomecare and the homecare community must continue to take a proactive approach to this issue. Whether it’s publishing a pamphlet for physicians and patients regarding the rules on Medicare payment for mobility equipment or making clinical assessments performed by a PT, OT or trained clinician a routine business practice, we must show CMS, and the general public, that legitimate DME providers are part of the solution and not the problem.

Kay Cox is CEO of AAHomecare. Contact her at 703-836-6263