Scooter Store bankrolls provider's fight with CMS

Saturday, December 31, 2005

REDDING, Calif. - The Scooter Store has begun bankrolling a California provider who lacks the cash to continue his high-profile fight with CMS over power wheelchair documentation.
In March 2005, a judge ruled that CMS wrongly demanded Maximum Comfort to repay Medicare $600,000 for not supplying additional documentation beyond CMNs for power wheelchair claims. Two months later, Medicare appealed the decision.
"We were down to the nubs when Medicare appealed the decision," said Tom Lambert, president of Redding, Calif.-based Maximum Comfort. "(The Scooter Store) bailed us out financially."
In a statement to HME News, Daniel Gibbens, executive vice president of marketing for New Braunfels, Texas-based Scooter Store, confirmed the "management agreement."
"We feel optimistic about their future," he said. "We believe the judgment won by (Maximum Comfort) is accurate, upholds the law and is in the best interest of beneficiaries and the industry."
Additionally, the Scooter Store has millions of dollars tied up in similar cases pending in several states, and if Medicare's appeal fails, it could create precedence and clear the way for favorable decisions in their cases, said an industry source.
There's debate, however, as to how much impact the Maximum Comfort case will have now that CMS has moved away from CMNs.
The case could question the legality of CMS's decision, said an industry source. "Maximum Comfort stood for the proposition that Congress has spoken to the documentation that a supplier can provide--a CMN," he said.
Other sources minimized the impact of the case. "The statute says CMS may create a CMN; it doesn't say it has to create a CMN," said Tim Webster, an attorney with Amarillo, Texas-based law firm Brown & Fortunato. "If the CMN goes away, the decision becomes irrelevant, except with respect to appeals of overpayments that pre-date the abolition of the CMN."