Taxpayers were billed $27 million for thousands of power wheelchairs that were not medically necessary for their users.
Hoveround was the subject of an audit released last week by the Department of Health and Human Services inspector general, which faulted the company for failing to meet Medicare requirements before it charged the government for its electric wheelchairs.
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In 2010, Hoveround provided 13,025 power wheelchairs to Medicare beneficiaries. Eighty-five percent of those who received the wheelchairs did not meet the necessary medical requirements, according to the audit. The findings were based on a sample of 200 individuals who received a power wheelchair from Hoveround.
"Hoveround often did not claim Medicare reimbursement for [power mobility devices] PMDs in accordance with Medicare requirements," according to the audit. "Hoveround complied with Medicare requirements for 46 of the sampled beneficiaries. However, for the remaining 154 sampled beneficiaries, Hoveround received payments for claims that did not comply with Medicare requirements."
Further, 171 of the beneficiaries were "determined to not meet medical necessity requirements by a medical necessity review contractor," or 85.5 percent.
In order to receive a subsidized scooter an individual must prove they need the equipment for daily living, and that a cane, walker, or manual wheelchair is insufficient. An in-person doctor’s visit with written documentation is also required.
The inspector general reported that Hoveround "did not ensure that Medicare requirements were followed to support the medical necessity" for its power wheelchairs, or ensure that claims had supporting documentation from a physician.
"On the basis of our sample results, we estimated that Medicare paid Hoveround at least $27,027,579 for [power mobility devices] that did not meet Medicare requirements during 2010," the audit said.
The company boasts that nine out of 10 customers receive their Hoveround for "little or no cost."
"If you meet the criteria, Medicare will pay 80 percent of the cost of your Hoveround and if you have met your deductibles, your supplemental insurance may cover the remaining 20 percent of the cost," the company says on its website.
Hoveround’s power chairs start at $2,495.
The inspector general recommended that Hoveround refund the $27 million to the government.
The company disputed the audit’s findings, arguing they were not told they needed to submit medical documents for the claims under review and that the inspector general conducted a biased investigation.
"Hoveround stated that [the inspector general] did not inform Hoveround that it was conducting a medical necessity review, and as a result Hoveround was not able to submit all of the necessary supporting evidence," the audit said. "Hoveround stated that [inspector general] influenced the medical review performed by the [Durable Medical Equipment Medicare Administrative Contractors] DME MACs and biased the results."
The inspector general maintained that the review was unbiased, and that they told the company they needed to provide medical records.
Hoveround did not return a request for comment by press time.