The SCOOTER Store, the nation’s leading provider of power wheelchairs, scooters and other mobility devices, expressed disappointment in the Centers for Medicare and Medicaid Services’ (CMS’) failure to clarify documentation requirements in its Final Rule, Conditions of Payment for Payment of Power Mobility Devices (PMDs), published this week.

Mike Pfister, President of the SCOOTER Store, pointed out that in December 2005, Congress passed legislation that called for CMS to publish a new rule and asked the agency to work with stakeholders to establish clear guidelines that would lessen the paperwork burden on physicians while creating certainty for suppliers when filling a PMD prescription. He said that unfortunately, the agency ignored congressional intent and republished a rule that Members of Congress and stakeholders identified as poorly designed to combat fraud and unacceptably vague regarding documentation issues. “Power mobility devices serve as a healthcare solution for thousands of people across the United States trying to conduct their activities of daily living,” Pfister said. “Without clear and consistent documentation guidelines, people who have a true medical need will experience a substantial delay as suppliers work with physicians, struggling to determine if enough medical information has been provided to successfully fill a prescription.”

Pfister said The SCOOTER Store has long supported the face-to-face requirement for prescribing power mobility products, and the face-to-face provision is consistent with the Medicare Modernization Act of 2003, which codified the primary role of the physician in the provision of power mobility equipment. The SCOOTER Store also supports increased standards and certification requirements for suppliers, as well as CMS’ extension of the timeframe for suppliers to receive prescriptions for a healthcare practitioner from 30 to 45 days. But, Pfister said, CMS unfortunately undermined the importance of these provisions by failing to provide the clarity desperately needed by physicians and suppliers in order to serve Medicare beneficiaries. “Failing to clarify the documentation requirements in the final rule creates uncertainty for legitimate suppliers whose claims can be arbitrarily denied by CMS. And, this uncertainty results in such a complex and confusing environment that it will be extremely difficult to identify and eliminate fraudulent actors,” Pfister stated.

Pfister said The SCOOTER Store will continue to provide positive recommendations to decrease fraud while ensuring a measure of objectivity and consistency in the Medicare PMD claims process.

Technorati Tags: medicare, medicaid, scooter store, medicare PMD

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