Mobility

OIG Finds PWC Documentation Lacking; Medical Necessity Next Up for Study

According to the Office of Inspector General, three out of five claims for standard and complex rehab power wheelchairs did not meet Medicare documentation requirements during the first half of 2007.
Now reading Page 2

In October, the OIG issued a controversial report on providers' costs to purchase power wheelchairs, saying that Medicare could have saved millions on PWCs if its fees had been the same as prices available on the Internet. But the HME industry's mobility segment immediately labeled the report as  flawed and misleading, pointing to the significant difference in cost between an online retail model and a Medicare provider model.

Now, the OIG said, it also plans to issue a report on the "appropriateness (e.g., the medical necessity)" of power wheelchair claims. In addition to determining whether beneficiary medical records supported the medical necessity of the power wheelchair, OIG will determine whether documentation from the suppliers and prescribing physicians was consistent.