Stakeholders prepare response on PMD repairs

WASHINGTON – Industry stakeholders believe a recent Office of Inspector General report on repairs for power mobility devices is “disingenuous.” 

The report’s title claims Medicare improperly paid DME suppliers an estimated $8 million of the $40 million it paid for power mobility device repairs between Oct. 1, 2018, and Sept. 30, 2019. 

“The report is very concerning,” said Seth Johnson, vice president of government affairs for Pride Mobility Products, during a recent industry webcast. “It’s full of erroneous and disingenuous information. Look no further than the title of the report.” 

The $8 million figure cited in the report is an extrapolation of what’s actually $41,137 in improper payments based on 100 sampled beneficiaries for whom 52 providers submitted charges for 922 repairs totaling $170,776.  

The report, which found that documentation didn’t adequately support the charges for repairs, is representative of the Catch-22 that providers are in, says Dan Fedor. They want to provide repairs in a timely way, but documentation requirements, particularly a requirement that there must be continued need documented in the medical record within 12 months of a repair, slow them down. 

“They want you to conduct repairs in a timely way, but there are all these issues they’re going to ding you on,” said Fedor, director of reimbursement and education for U.S. Rehab, a division of the VGM Group. “If you do it in a timely way and forego the continued need requirement, for example, they’re going to ding you on it.” 

Stakeholders, including a workgroup of AAHomecare’s Complex Rehab & Mobility Council, are combing through the report and working on a written response to the OIG.  

“The thing with OIG reports, they have a long-term impact,” said Mina Uehara, director of regulatory affairs for the association. “What we want is for the association to have a stance on it, so years later, our members have a physical letter on that stance.”