Costs and Savings in Medicare Change on Wheelchairs - Medicare administrators late last fall began to take a closer look at reimbursement requests for power wheelchairs, an effort now saving the government millions of dollars. [New York Times Healthcare News] The beginning of this article talks about the hardships of small businesses and patients who are having trouble getting Medicare to pay for power wheelchairs. Sure, new rules may make it more difficult for everyone to get Medicare to pay for power wheelchairs, but the rules were enacted to control terrible abuse of the system. The article gives this example, “In Harris County, Tex., Medicare paid for more than 3,000 power wheelchairs in 2001. A year later, it paid for 31,000, reflecting what federal officials said was $84 million in fraudulent claims.” Is there a middle ground? Yes, but it requires more staff time, at a time of great budget pressure. The longterm savings would make it worthwhile for a case manager empoyed by the Medicare carrier to visit certain people requesting expensive equipment. For example, rather than denying borderline prior authorization requests, a site visit could be offered or the request could be denied. Prior authorization statistics for each physician and DME provider should be kept and monitored. If fraud perpetrators knew that there was a high chance of the patient receiving a visit, they’d look other ways to make money. Of course, also continue to use data analysis to make sure you’re controlling the fraud.