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Homecare Community Dismayed that Medicare Will Start Prior Authorization for Wheelchairs without a Clinical Template for Physicians to Document Need
Date:8/7/2012

are resolved and some beneficiaries may never be approved for the equipment.

Furthermore, there is plenty of evidence to support the stakeholders' belief that care will be jeopardized. Recently, a Comprehensive Error Rate Test (CERT) report on power mobility devices in the jurisdiction covering 17 states, including California, found a 100 percent error rate. That score supposedly signifies that no power wheelchairs provided to Medicare beneficiaries in that region met the reimbursement and coverage criteria.  That CERT result underscores the fact that the guidelines for documenting medical need for mobility devices are so flawed and subjective that virtually every reimbursement claim can be found to be in non-compliance.

That's why a clinical template is so crucial.  The template would standardize the collection of a patient's medical information provided by physicians.  Instead of trying to figure out the confusing guidelines on what patient data CMS is seeking, a template would ask physicians for specific information.

CMS agrees that a template may be helpful and is developing one. But the agency failed to link it to implementation of the prior authorization program. Mobility stakeholders are also concerned that when CMS begins the pilot program physicians won't have the tools needed to make the program successful.

"Clearly, patient care is going to be jeopardized when CMS begins prior authorization without a clinical template," said Wilson.  "Some of the most vulnerable people in our society, seniors and people living with physical disabilities, will face delays in receiving power wheelchairs or won't get them at all.  It's time for CMS to acknowledge that it must fix the system for documenting a patient's medical need for power wheelchairs."

Moreover, stakeholders are also concerned that in announcing the start of prior authorization, CMS touted the program as one that would reduce fraud and abuse. <
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SOURCE American Association for Homecare
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