GAO Recommends Ways to Curb Fraud, Abuse

Washington

In a December report, the Government Accountability Office (GAO) recommended steps Medicare should take to help curb abuse of the program’s power wheelchair benefit.

Requested by Sen. Charles Grassley, chairman of the Senate Finance Committee, which oversees Medicare and Medicaid, the report presents a status update on power wheelchair issues discussed at a congressional hearing held in April.

Based on its findings, the GAO recommended that CMS take four actions:

1) Develop a process within CMS to focus on trends in Medicare spending and disproportionate Medicare payments;

2) Implement a revised Certificate of Medical Necessity (CMN) incorporating key elements of power wheelchair coverage criteria;

3) Strengthen the standards for Medicare DME suppliers;

and 4) Direct the National Supplier Clearinghouse (NSC) to conduct routine out-of-cycle site visits to suppliers suspected of billing improperly.

“Every dollar that’s lost to waste, fraud and abuse is a dollar that doesn’t go to beneficiaries who need the services and equipment provided by Medicare,” Grassley said. “With power wheelchairs, the greedy are too often taking what should go to the needy.”

The report, titled Medicare: CMS’s Program Safeguards Did Not Deter Growth in Spending for Power Wheelchairs, report number GAO-05-43, is available on the GAO’s Web site at www.gao.gov.