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Tag: Power mobility devices


Also Noted

CMS adjusts requirements for replacements

July 18, 2024HME News Staff

WASHINGTON – CMS will require prior authorization for all power mobility devices being replaced within the five-year useful lifetime effective June 2, NCART reports. Providers should submit prior authorizations as an expedited request and the agency will process them within two business days. For wheelchairs being replaced due to loss, theft or irreparable damage, the following should be included with the request: information and/or detailed reports that explain the reason leading to the need...

NCART, Power mobility devices, Prior Authorization


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Also Noted

Two charged in Medicare scam for power mobility

August 31, 2023HME News Staff

 BROWNSVILLE, Texas – Maria Luisa Yzaguirre and Jeremiah Yzaguirre, both of Harlingen, Texas, have been charged with conspiracy to commit health care fraud, aggravated identity theft and money laundering. The charges allege that between 2019 and 2023, the Yzaguires submitted more than $14 million in claims to Medicare for power wheelchairs, power scooters, parts and repairs for 37 individuals. In multiple instances, they allegedly billed Medicare more than $600,000 for parts and repairs...

Fraud, Medicare, Power mobility devices


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OIG: Medicare improperly paid for PMD repairs

June 2, 2022HME News Staff

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.)...

Power mobility devices


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Mobility

SWO alleviates confusion for PMDs

February 6, 2020Liz Beaulieu, Editor

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...

Dan Fedor, Power mobility devices


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Mobility

CMS shifts mobility codes into nat'l prior authorization program

June 8, 2018Liz Beaulieu, Editor

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...

PMD demo, Power mobility devices, Prior Authorization


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Also Noted

AAH surveys providers on PMD demo

May 15, 2018HME News Staff

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...

AAHomecare, Demonstration, Power mobility devices, Prior Authorization, Survey


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Also Noted

CMS plans to extend PMD demo

February 9, 2018HME News Staff

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...

Demonstration, Power mobility devices, Prior Authorization


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Mobility

Q&A: Permobil's Darren Jernigan on a tough election

November 23, 2016Tracy Orzel

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...

Darren Jernigan, Mobility, Permobil, Power mobility devices


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Mobility

PMD claims without G code are suspect, OIG says

January 23, 2015HME News Staff

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...

Office of Inspector General (OIG), Overpayments, Power mobility devices


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Mobility

Audited providers fight fire with fire

July 24, 2013Elizabeth Deprey

Faced with more audits for power mobility devices than ever, providers are taking drastic measures to appeal denials.  “I'm going to interview patients on video and bring it to the administrative law judge,” said Cory Baker, compliance officer at Abilene, Texas-based Choice Medical Supply. “I don't see how they could see this video and say the patient doesn't need it.” Baker says 45 of his company's claims have been audited. “None of these...

Audit, Power mobility devices


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