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OIG Report on Power Wheelchairs Shows that CMS Must Do More to Educate Physicians
Date:7/11/2011

WASHINGTON, July 11, 2011 /PRNewswire-USNewswire/ -- A study released yesterday by the Office of Inspector General (OIG) at the Department of Health and Human Services illustrates the pressing need for the Centers for Medicare and Medicaid Services (CMS) to give physicians concrete direction to meet policy and compliance mandates.  The report found that more than half of Medicare power wheelchair claims submitted in the first half of 2007 did not meet medical necessity requirements.  However, the vast majority of audited claims that were considered improper were the result of a lack of full documentation by the prescribing physician in the patient's medical record.  The report validates what the American Association for Homecare (AAHomecare) has been advocating for years:  lawmakers need to hold CMS accountable to establish clear and objective guidance to the physician community in the power mobility benefit.

AAHomecare President Tyler Wilson noted that the OIG report, "Most Power Wheelchairs in the Medicare Program Did Not Meet Medical Necessity Guidelines" (OEI-04-09-00260, July 2011, http://oig.hhs.gov/oei/reports/oei-04-09-00260.pdf) does not focus enough attention on the real problem—CMS has an expectation of documentation in the medical record without providing a tool for all levels of prescribing physicians to follow.  And the report highlights the fact that suppliers are lacking understanding with respect to when the medical documentation meets policy requirements." 

Walter Gorski, AAHomecare Vice President of Government Relations, added, "power wheelchair providers are being put into a position of educating physicians on a very complex policy and then judging the physician's medical record competency.  This should not be the power wheelchair provider's role.  The HME provider needs to feel confident that the physician is do
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SOURCE American Association for Homecare
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