Then and Now: CMS Hails Effects of Operation Wheeler Dealer

DALLAS–Sixteen months after the cessation of a concentrated
effort to crack power wheelchair fraud in Harris County, Texas, CMS
is still seeing a decrease in fraudulent claims, officials
said.

“CMS has noted significant changes because of our efforts to
curtail wheelchair fraud in Harris County,” said Julia Lathrop,
special assistant to the regional administrator for CMS in Dallas.
“The number of claims for power wheelchairs dropped significantly,
the claims denial rate is more appropriate and a number of
wheelchair suppliers’ Medicare numbers were revoked for various
reasons.”

While Operation Wheeler Dealer officially ended on Oct. 1, 2005,
CMS and its contractors still “monitor wheelchair activities in
Harris County on a regular basis,” Lathrop noted.

The initiative was CMS’ response to massive PWC fraud schemes
that came to light in Houston, which is located in Harris County.
Medicare paid more than 31,000 claims for power chairs in Texas in
2002 compared to 3,000 in 2001, officials said when Wheeler Dealer
was launched.

The agency put the 10-point initiative into place in September
2003. Among other things, the plan suspended issuance of new
provider numbers; required all payments for motorized wheelchairs
in Harris County to be scrutinized and approved by CMS staff on a
special task force; required the medical provider to see the
patient before prescribing a wheelchair or scooter; and targeted
power wheelchairs as the “first item analyzed for potential
inherent reasonableness adjustments.”

Harris County HME providers were also required to attend
training programs on CMS medical policies.

While Lathrop said the current number of claims for power
wheelchairs was not “readily available,” she cited these
statistics:

–Submitted charges in 2002, the year before Operation Wheeler
Dealer went into effect, added up to $154,774,372; by Oct. 1, 2006,
they had dropped to $20,150,712.
–The total number of beneficiaries (billed) also dropped
dramatically, from 21,353 in 2002 to 3,354 in 2006.
–As of Feb. 26, 2004 (when the National Supplier Clearinghouse
completed site visits in the area), supplier numbers for 355 Harris
County companies had been revoked.

Lathrop added that “CMS definitely believes that Operation
Wheeler Dealer was a success.” She noted the initiative also gave
the agency ammunition to fight fraud in other areas.

“There are a number of activities related to OWD that could be
replicated elsewhere, if needed,” she said. “These include targeted
medical review; on-site visits to suppliers to identify
non-existent or out-of-compliance suppliers; and training of
suppliers and physicians on medical policies, claims submittal and
requirements for the particular products/services.”

For more on providers in Harris County, check the upcoming
spring issue of HomeCareXtra.