Another missive from the OIG

 - 
09/03/2009

In “Power Wheelchairs in the Medicare Program: Supplier Acquisition Costs and Services,” the OIG found that, in the first half of 2007, Medicare allowed, on average, $4,018 for standard power wheelchairs that cost suppliers $1,048. Medicare and its beneficiaries paid suppliers $2,970 beyond the acquisition cost to perform an average of five services and cover general business costs.

Medicare allowed, on average, $11,507 for complex power wheelchairs that cost suppliers $5,880. Medicare and its beneficiaries paid suppliers $5,627 beyond the supplier’s acquisition cost to perform an average of seven services and cover general business costs.

To perform the study, the OIG requested documentation from suppliers that showed what they paid for 375 standard and complex power wheelchairs. It also requested documentation of the services that they performed in conjunction with supplying the power wheelchairs. It did not, however, determine the cost of performing these services or other general supplier business expenses, such as billing, accreditation, staff salaries or facility maintenance.

Wait a minute...

Why didn't the OIG take the next step and determine the cost of services and business expenses? Since many of the industry's arguments for preserving reimbursement have to do with the cost (and importance) of the services providers furnish and the business expenses they have (especially compared to Internet providers), isn't that where the rubber hits the road?

Is that what the OIG's eyeing for its next missive? Are providers prepared to justify $2,970 per standard power wheelchair and $5,627 per complex power wheelchair to cover services and business expenses?

Liz Beaulieu

Comments

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