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Government Report on Power Wheelchair Use in Medicare Triggers Misleading News Coverage, Says American Association for Homecare
Date:8/12/2011

media nor government investigators are focusing on the fact that 52 percent of the claims that the OIG reviewed had insufficient information for the investigators to determine whether or not a Medicare patient had a medical need for a power wheelchair.

"This is the statistic that puts the real problem in perspective," said Georgie Blackburn, who is vice president at BLACKBURN'S, a home medical equipment provider in Tarentum, Pa.   She added that the 2007 period reviewed by the OIG was just after CMS revised documentation rules, but failed to properly educate physicians and providers on the changes.

"The bottom line is that providers file extensive paperwork with their reimbursement claims so they can be repaid for the power wheelchairs that they have already purchased from manufacturers and delivered to Medicare beneficiaries," she said. "We badly want to provide CMS with all the information they need to process claims so our businesses can stay open.  If information is missing, it's because their guidelines are confusing physicians and providers."

One of the major problems is that providers have to depend on physicians to supply patient medical information. Blackburn said that CMS has failed to supply physicians with a tool or template to document the patient medical information that is now being required. When the information isn't available to be reviewed, she said the claim falls into the insufficient information category and the providers are wrongly blamed.

"Physicians are used to documenting patient medical history for their purposes, not for what CMS is looking for to document medical necessity," she said.  "CMS needs to work with physicians and providers to develop a policy that works for all the stakeholders."

The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community who serve the medical needs of millions of Americans who r
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SOURCE American Association for Homecare
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