Tag: Power mobility devices

WASHINGTON – Medicare improperly paid $7.9 million for power mobility device repairs between Oct. 1, 2018, and Sept. 30, 2019, according to a new report from the Office of Inspector General.  The OIG looked at Medicare Part B paid claims for 37,013 beneficiaries for whom suppliers submitted charges for 244,667 claim lines totaling $40.1 million for PMD repairs provided during the audit period.  (A claim line represented one PMD repair for a beneficiary on a single date of service.)...

WASHINGTON - Providers of power mobility devices have perhaps the most to gain from a new standard written order that went into effect Jan. 1, stakeholders say.The SWO replaces four types of orders, including the seven-element order, which was a sticking point particularly for PMD providers.“Some providers were sending me thumbs up emojis when I told them about the SWO,” said Dan Fedor, director of reimbursement and education for U.S. Rehab, a division of the VGM Group.The elimination...

WASHINGTON - CMS has added seven codes for complex rehab power mobility devices and five codes for support surfaces to the national prior authorization program, AAHomecare reports.The agency will roll the PMD codes into the program within 90 days, or July 21 by the association's estimates.The support surface codes will added in two phases, within 90 days in California, Indiana, New Jersey and North Carolina, and within 180 days, or Oct. 19, 2019, by AAHomcare's estimates, in all states.The codes...

WASHINGTON - CMS says a demonstration project requiring prior authorization requests for power mobility devices in 19 states will become permanent and will expand to all states.CMS announced June 1 that it will transition nearly all of the codes included in the demo project, which was set to expire on Aug. 31, to its national prior authorization program on Sept. 1. Currently, the agency has two codes in the national program: K0856 and K0861, two complex rehab codes.“This is something the industry...

WASHINGTON - AAHomecare's Complex Rehab & Mobility Council is collecting feedback from providers about the prior authorization demonstration project for power mobility devices currently taking place in 19 states. Responses to the council's brief online survey are due by May 25. “The PMD prior authorization program has been a win-win for the HME industry and for CMS, and information from this survey will bolster our efforts in working toward a nationwide, permanent prior authorization program...

WASHINGTON - It looks like CMS plans to extend a demonstration project requiring prior authorizations for power mobility devices, according to a notice posted in the Federal Register on Feb. 7. The demo, in place in 19 states, is set to expire at the end of August. The Paperwork Reduction Act of 1995 requires federal agencies to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of...

NASHVILLE, Tenn. - This election hasn't been easy on anyone, even on those who won. “I was one of the few democrats that survived in Tennessee,” said Darren Jernigan, director of government affairs at Permobil, who is about to start his third term as a state representative. “(The elections) are every two years—it's wearing me out.” HME News recently spoke with Jernigan about “serving two masters” and what stakeholders should expect in the new political climate.HME...

WASHINGTON - Power mobility devices and orthotic braces are among the product categories under review by the Office of Inspector General, according to a new report.The OIG released its Mid-Year Update for 2016 on June 7.Necessary and compliantThe OIG will perform several reviews to determine whether claims were medically necessary and compliant with Medicare requirements. Affected product categories include orthotic braces, nebulizers and related drugs, and power mobility devices.System editsThe...

SARASOTA, Fla. - The Office of Inspector General's recent audit of mobility giant Hoveround raises questions about how the agency applies standards and extrapolates overpayment amounts.Out of a sample of 200 randomly selected Hoveround claims for PMDs from 2010, the OIG found 154 did not meet Medicare requirements. Of those, the agency says 144 did not meet medical necessity requirements and 10 had incomplete documentation.But Hoveround argues the OIG applied incorrect standards and is calling for...

WASHINGTON - The Office of Inspector General (OIG) calls into question claims for power mobility devices (PMDs) without corresponding G-code claims in a new report.CMS introduced G0372 in 2005 for physicians to establish and document the need for PMDs.The OIG found that for PMD claims with corresponding G-code claims, Medicare paid the claims in accordance with federal requirements for face-to-face requirements of beneficiaries. It found for claims without corresponding G-code claims, however, that...