Senate to examine PWC fraud and abuse

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Sunday, April 18, 2004

April 19, 2004

WASINGTON - Senator Charles Grassley will convene a hearing of the Senate Finance Committee next Wednesday, April 28, to examine the issue of fraud, abuse and waste in the power wheelchair market.
Sources say panels from CMS, the GAO and the OIG will testify before the committee. None from the industry is expected to testify.
At the hearing, the OIG will reveal the contents of two reports on power wheelchairs; one looks at pricing, the other examines coverage criteria.
Grassley in late February sent a letter to CMS, asking Medicare administrators to explain how it developed a December coverage clarification that limits power wheelchairs to beneficiaries who are bed- or chair-confined.
"While ensuring that we do all that we can to eliminate fraud  and waste from government programs," Grassley wrote in the letter, "I also want to be certain that we are not inappropriately preventing our eligible citizens from obtaining the medically-needed equipment  they are authorized to receive."
CMS has since sent a letter to Congress, stating its intent to rescind that clarification. But after a recent Open Door forum on the subject, the industry is still looking for clarity on the issue from CMS.
The industry has gone to great lengths to educate Grassley on issues about HME in general, and the power wheelchair, specifically, according to John Gallagher, vice president of government affairs at The VGM Group.
“He doesn’t have an axe to grind in this industry,” said Gallagher. “He doesn’t have an agenda, but he is looking for cost-savings.”
Grassley will stand as the keynote speaker at VGM’s Heartland conference in June.

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