OIG: Wheelchair documentation is more often wrong than right
By Liz Beaulieu, Editor
Updated Wed December 30, 2009
Three out of five claims for standard and complex power wheelchair claims did not meet Medicare documentation requirements during the first half of 2007, the Office of Inspector General (OIG) states in a new report. Those claims accounted for $112 million of the $189 million in total improper payments allowed for that time period.
The OIG based its report on a review of 375 claims for standard and complex power wheelchairs.
Other findings in the OIG's report:
- Two out of five claims had multiple errors;
- Suppliers submitted incomplete documents almost three times as often as they failed to submit requirement documents;
- Complex power wheelchair claims had a higher documentation error rate than standard power wheelchair claims; and
- Standard power wheelchair claims submitted by low-volume suppliers had a higher documentation error rate than those submitted by high-volume suppliers.
(Anyone else find this last finding especially interesting? Does it mean that a provider like The Scooter Store has the cleanest claims?)
The OIG recommends that CMS improve compliance with documentation requirements by conducting additional reviews of claims; recovering overpayments and considering further actions against suppliers that do not meet requirements; and increasing education for suppliers and prescribing physicians about requirements. Additionally, the OIG recommends that CMS take action on the sampled claims found to be in error. CMS concurred with the OIG's recommendations.
To read the OIG's report in full, go to: http://oig.hhs.gov/oei/reports/oei-04-07-00401.pdf.
Liz Beaulieu
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