Report underscores problems with durable medical equipment Medicare claims process, group says

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Report underscores problems with durable medical equipment Medicare claims process, group says
Report underscores problems with durable medical equipment Medicare claims process, group says

A new report from the Department of Health and Human Services Office of Inspector General confirms that the regulatory documentation requirements for durable medical equipment Medicare claims are “confusing, onerous and must be improved,” according to a DME provider group.

The December 2009 OIG report found that three out of five Medicare claims for standard and complex rehabilitation power wheelchairs made during the first half of 2007 did not meet Medicare documentation requirements. When only complex rehabilitation wheelchairs were considered, a mere 7% of claims met Medicare's requirements, according to the OIG report. The report does not indicate a problem with provider compliance. Rather, it shows just how confusing and difficult it is to comply with the Medicare claims process, the American Association for Homecare, which represents durable medical equipment providers, suggested.

During 2005 and 2006, there were “numerous and often contradictory changes in coding, documentation requirements, and compliance standards,” said Tyler Wilson, president of AAH in a press release. The Centers for Medicare & Medicaid Services, which governs the requirements, should create simpler, better guidelines to address the flaws and regulatory burdens of the claims process, Wilson says.