Article preview from "The Gray Sheet"- November 21, 2011
The Medicare agency plans to launch a demonstration project next year on prepayment review and prior authorization of power mobility devices, but it faces resistance from industry trade group AAHomecare.
Article preview from "The Gray Sheet"- November 21, 2011
In an attempt to reduce Medicare fraud and abuse, CMS last week announced plans to launch a demonstration project early next year to test prior authorization requirements for power mobility devices prescribed in seven states.
Over the years, Congress, the Government Accountability Office and the HHS Office of Inspector General have monitored power wheelchairs and scooters for signs of Medicare overpayment and overutilization.
According to CMS, the seven states in the demo program – California, Texas, Florida, Michigan, Illinois, North Carolina and New York – accounted for 43% of the $606 million in Medicare expenditures for power mobility devices last year.
The three-year project is designed “to help ensure that Medicare only pays for power mobility devices that are medically necessary under existing coverage guidelines, thus limiting fraud, waste and abuse,” CMS said in a Nov. 15 fact sheet.
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