OIG Testimony In Congress Includes Reference to Power Wheelchair Report

On July 28, 2011 the Inspector General gave testimony (read the transcript of the testimony) to a Congressional Committee regarding Medicare fraud and abuse.  As part of his testimony he referred to the findings of the OIG report on power wheelchairs that was published this month.  Again, power wheelchairs were put in a bad light and there is even a mention of “rehabilitative” power wheelchairs.  See the attached testimony. 

The recent OIG report was seriously flawed:

• The data is over 4 years old AND the review was conducted during the first months following an historic MAJOR overhaul of both coverage policies and required documentation for power wheelchair claims. 
• It was a time of mass confusion for both suppliers and physicians as to required documentation which necessitated CMS to issue multiple clarifications throughout 2007 to fully explain what they were looking for.  The CMS clarifications continued into 2008 and 2009.  The documentation requirements went from one or two pages to, in many cases, ten to twenty pages. 
• Given this year of confusion the results were no surprise: 52% were cited as “not having all the required documents”.  It is understandable that the OIG found all these problems given the introduction of much more complex documentation requirements and the massive confusion in the physician and supplier communities at that time. 
• The report did NOT indicate these chairs were not needed by the Medicare beneficiaries.
• It’s CMS’s convoluted paperwork policies and communications that created the problems for the good guys. 
• NCART is fully supportive of appropriate documentation and review of power wheelchair claims, but it should be done in an effective manner and include clear guidelines for physicians, other clinicians, and suppliers along with reasonable documentation requirements.

NCART and NRRTS will be responding in writing. NCART will be setting up a meeting with the OIG to discuss this matter and to review with them the work we are doing around a Separate Benefit Category.  In the meantime, please be prepared to respond with the above points should you hear the OIG report being referenced.