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

cumenting everything CMS expects to see within the medical record and the physician needs to feel assured that the information they are recording in the medical record meets policy requirements, guaranteeing coverage for their patients." 

Gorski added that "this problem could be solved very quickly if CMS were to create a mandatory comprehensive medical necessity assessment template for use by physicians to document proof that the power wheelchair is medically required."

It is also worth noting that the study takes a snapshot picture in time when confusion about what was required of suppliers and physicians was at its peak. The OIG study looked at power wheelchair claims immediately after CMS had completely overhauled the power mobility benefit in late 2006 (including coverage criteria and coding) and then immediately began issuing clarifications and bulletins, which led to a high level of confusion in the power wheelchair provider community.  As a result, auditing of these claims was very subjective, leading to misleading conclusions.  Moreover, the OIG report in no way implies that power wheelchair providers are participating in any form of unscrupulous or fraudulent behavior.  Since the OIG study was undertaken, power wheelchair providers must be accredited and comply with much more stringent quality and operational standards. 

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 require oxygen equipment and therapy, wheelchairs and assistive technologies, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states.  Visit www.aahomecare.org/athome


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SOURCE American Association for Homecare
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