Provider follows Maximum's lead, appeals ruling

Friday, September 30, 2005

LARGO, Fla. - Another provider of power wheelchairs has appealed a Medicare overpayment to a federal district court, arguing that CMS isn't allowed to request information beyond the CMN to prove medical necessity. In all, CMS wants Gulf Coast Medical Supply to repay about $200,000 related to 16 power wheelchair claims, said the company's attorney, Lester Perling. Since Maximum Comfort, a northern California HME, argued and won a similar case at the district court level in 2004, other providers have adopted the defense at the federal district court level. So far, none of those cases have been ruled on. "With one case in California, the precedent is not that strong," Perling said. "But if you have different decisions coming out of different districts it's stonger."