Scooter Store replies to senatorial call-out

Monday, February 25, 2013

NEW BRAUNFELS, Texas – Two U.S. senators may think The Scooter Store should return more in overpayments to Medicare, but the provider stands by the $19.5 million it has agreed to repay.

In a Dec. 19 letter to CMS, Sens. Richard Blumenthal, D-Conn., and Herb Kohl, D-Wis., asked the agency if it planned to have The Scooter Store return more overpayments to Medicare. According to the letter, in April 2011, after an independent audit, The Scooter Store notified CMS of overpayments ranging from about $32 million to $64 million. In November 2011, the company notified CMS of another round of overpayments ranging from about $14 million to $24 million, the letter states.

“Why did CMS accept the repayment amount of $19.5 million, which is significantly less than overpayments identified?” the letter states.  

The Scooter Store’s answer: Some of the overpayments identified by the auditor were actually medically necessary claims.

“After we conducted an in-depth investigation of the sample of files reviewed by the (Independent Review Organization) for the two year period of time from May 2009 to May 2011, we determined that some of the claims the IRO had disallowed were in fact medically necessary for those patients,” stated The Scooter Store in a statement to HME News. “The Scooter Store recalculated the potential overpayment and offered to repay an extrapolated amount of $19.5 million to CMS. This represents less than 4% of our Medicare payments for that time period.”

The Scooter Store stated that it is in “full compliance” with the payment plan set up for the $19.5 million, and that, although its corporate integrity agreement is over, it plans to continue to focus on compliance.