3 in 5 Medicare power wheelchair claims are improper

NEWS IN BRIEF — Posted July 18, 2011

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The Medicare program paid $95 million in improper payment for power wheelchairs during the first six months of 2007, according to a Dept. of Health and Human Services Office of Inspector General report released in July.

An audit of 375 claims showed that 61% lacked the documentation necessary to support the patients' need for power wheelchairs. The inspector general found most claims did not meet the medical necessity guidelines outlined by the Centers for Medicare & Medicaid Services, the report stated.

The OIG recommended that CMS strengthen enrollment screening standards for medical equipment suppliers and review records from prescribing physicians. CMS also should continue to educate physicians and suppliers to ensure that patients receive medically necessary power wheelchairs that are appropriate for their mobility needs, the inspector general said.

The Medicare agency has anti-fraud tools in place to scrutinize wheelchair suppliers, CMS said in response to the study. All suppliers are subject to enhanced screening standards, the agency said.

Note: This item originally appeared at

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