Medical equipment suppliers, working in cahoots with doctors, have often been caught executing get-rich-quick schemes involving power wheelchairs. They're profitable scams, since suppliers can buy motorized chairs for $900 each but bill Medicare about $6,000 per item, Medscape reported.
California physician Robert Glazer, M.D., for example, was recently indicted on healthcare fraud charges for--among other issues--overprescribing power wheelchairs. He ordered an average of 134 per year for eight years, whereas his peers may have prescribed one or two, the article noted.
Prosecutors say Glazer ordered wheelchairs for people who didn't want, need or expect them. His marketers reportedly enticed patients to participate in the scheme by offering freebies ranging from kitchen blenders to rice and beans, Medscape noted.
Power wheelchairs qualify for Medicare payment only when beneficiaries have mobility problems that can't be managed using cheaper equipment such as canes, scooters or ordinary wheelchairs.
In the first half of 2007, only 9 percent of power wheelchairs provided to Medicare patients were medically necessary, and the need for another 52 percent of these items couldn't be determined, Medscape reported. Many motorized chairs "sit unused in garages, closets and living rooms, collecting dust or holding up television sets," the article stated.
Beyond wasteful spending, there's potential harm here: Needless reliance on power wheelchairs can cause physical atrophy in patients, Medscape reported.
In a related case, the government intervened in a False Claims Act lawsuit against the Utah-based equipment supplier Orbit Medical, Inc. The lawsuit alleges Orbit representatives increased power wheelchair sales by altering and forging physicians' prescriptions and documentation, the U.S. Department of Justice announced.
Responding to overutilization in this benefit category, the Centers for Medicare & Medicaid Services proposed a new precertification program for durable medical equipment, prosthetics and orthotics. And CMS plans to expand a demonstration project providing preauthorization of motorized wheelchairs in 19 states rather than the current seven, as FierceHealthFinance reported.