Tuesday, March 13, 2012

Medicare Cracks Down On Power Wheelchair Claim Fraud


You can hardly leave the house these days without seeing someone riding around on one of those power wheelchairs. And if it seems like some of the people using them don't really need them and should be up and walking around, there might just be a very good reason for that. Here is the Tampa Bay Times with the story:
Whether covered by insurance or not, many Americans have power wheelchairs and scooters, as anyone visiting a supermarket or shopping mall can attest.

Now Medicare says it has been spending far too much on them, and Florida is one of the first states where the agency is cracking down.

In 2009, the most recent year for which figures were available, Medicare spent $723 million on power wheelchairs and scooters. And after a study, the agency estimated that at least 60 percent of claims were paid despite shoddy paperwork or were for devices that the recipient didn't need.
So just how bad is this form of Medicare fraud?
How much is Medicare losing? A review of power wheelchair claims for the first part of 2007 found that more than half of $189 million in claims were medically unnecessary or so poorly documented it was impossible to tell whether they were needed, resulting in $95 million in improper payments.
But beyond scammers trying to rip off there government, there is a larger problem here:
Dr. William Quillen, who directs the University of South Florida's school of physical therapy and rehabilitation science, agrees that some people really do need these devices.

"But there are also people you see at Target, Walmart or the mall (using power devices), and there doesn't appear to be any readily apparent medical need," he said.

But if you're capable of rehabilitation, the longer you spend in a power chair makes it more likely you'll never get out of it.

"They lose muscle strength and gain weight," said Kavita Jain, a therapy team leader at the Florida Hospital rehab unit. "We view it as equipment of last resort."

Etman said she thinks some doctors don't want to lose a patient by taking a tough stand, and so they sign the prescription.

"But they don't realize that it's hindering the patient, not helping them," she said.

Quillen said patients often ask about power chairs and scooters.

"Our first line of response is, 'let's not get down that road until we complete your rehab,' " he said. "We're not going to throw in the towel."

Staying active is especially important for people with chronic conditions such as diabetes, heart disease and obesity.

"It's kind of move it or lose it," said Dr. Richard Morrison, a Tampa heart surgeon. "We want them up and moving. If they stop that . . . (their) cardiovascular system isn't going to be in good shape."

Etman said she sometimes gets patients who have used a power chair for years.

"They hate us," she laughed. "We're trying to get them to where they can use a walker or a cane, or nothing, and they don't want to."
I really cannot fathom the mentality of a person who would rather be helplessly confined to a wheelchair rather than have the freedom to get up and walk around on their own. A few years ago, I suffered a total ACL tear and could not walk without crutches for about a month after the knee operation. Being essentially confined to my couch for all that time drove me absolutely stir crazy. I couldn't wait to get the physical therapy started so I could start moving around without assistance again.

The bottom line with this story is that you have several of the very worst traits of modern America all intertwined: corporate greed on the part of the companies that sell the chairs, an unaccountable big government program carelessly throwing taxpayer money away, and patients who have been conditioned to be lazy and helpless while expecting someone else to pick up the tab for their bloated medical expenses. It's upon reading stories like this one that you begin to realize just how traumatic collapse is eventually going to be for a very large percentage of the population.


Bonus: For anyone who doesn't realize that this band actually recorded more songs than just "Stuck in the Middle With You"

14 comments:

  1. "I really cannot fathom the mentality of a person who would rather be helplessly confined to a wheelchair rather than have the freedom to get up and walk around on their own."

    Me neither. Not long ago I was in the supermarket and saw a youngish looking woman in one of these, with a child and older person with her (both walking). I got the feeling she did not really need the thing, I don't think I could explain why, just an impression I got. (Outside my office building, I sometimes see other persons with them who DEFINITELY need them.) Anyway, I felt guilty about my suspicions, and went on my way.

    But apparently there really are persons who would prefer to sit in one of these things and be ambulated. Learned helplessness?

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  2. These are the sort of people that view Wall-E as the best possible future. They make me sick.

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  3. We moved back to the US 4 years ago after years of living overseas....where things are....very different...The adjustment back to the US was not easy.

    I was in a big US superstore at the deli counter. Fat people were whirring around the market in these electric shopping cart contraptions, their baskets stuffed full of ersatz edibles not really recognizable as FOOD. They were not old and feeble, just too fat to walk--they clogged the aisles in these store provided electric shopping carts and lined up at the deli to buy pre-made salads and stuffings to take away.

    It made me sad to see they'd gone so far as to sacrifice their own mobility just to chock their faces with toxic foodstuffs that were clearly ruining their lives.

    If you make bad choices like this in other countries you will die. In America you get special treatment. We are lost culture.

    gardener1

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    Replies
    1. "A lost culture" - Sadly...much as I often which it were not so.

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  4. We were shocked when we came back to America to see how very fat the people were.

    In a dozen other countries I never saw ONE person as fat as Americans are. It is unknown, unseen, unheard of. The waddle Americans have is untranslatable, I have never seen it anywhere else in the world. We are uniquely obese, unfit, slovenly--and I observe that our intellects have followed suit.

    Sloppy of body seems to go hand-in-hand with slovenly of mind. It is just my observation.

    When asked overseas, we sometimes claimed to be Canadian. It was better.

    gardener1

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  5. The American public would be shocked at how much fraud is committed by the largest seller of these chairs....the company who's commercials you see a dozen times during every episode of The Price is Right. This company is a sales organization. You hit the nail on the head with corporate greed. The owner of this company is the king of greed. They brag that their confetti budget is larger than the total operating costs of most smaller companies, they take their employees on cruises to Mexico, the owner has a beautiful ranch....all paid for by Medicare! When the government made them repay 4 million dollars because of questionable billing they claimed that this was a victory and that Medicare can't touch them. They claim to be the most compliant company regarding Medicare regulations, but yet they force their delivery people to deliver a power wheelchair even if the customer appears mobile. "Oh they were just having a good day". Medicare needs to investigate this company for all of the fraud they commit on a daily basis. The owner is well aware of the fraud...his lavish lifestyle depends on it. There needs to be an outcry and a demand that this fraud will not be allowed. The government needs to be aware of the payola to lobbyists from this company just to have support in Washington. This company does not live by it's own core ideologies......"Always do the right thing" is a joke, unless the right thing is ripping off the taxpayers and keeping customers immobile.

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  6. I need a heap,knee and left elbow, replacement. But i did pay off my own pocket for the E.chair i have. Its true,i have seen fat lazy people using, this E.chairs, paid by the gov.

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  7. Fraud was rampant in the early 2000s that gave just about anyone with a doctors note the ability to acquire an electric wheelchair. The restrictions in place are necessary but unfortunate for some that really need them.

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  8. Keep in mind that some people who appear normal aren't just being lazy always. My mom is a double amputee who takes good care of herself, walks normally to the untrained eye, and is otherwise relatively healthy. But she can't afford new legs when she needs them so her limit on standing leg time is about 2 hours before terrible blisters start. Those two hours are easily used in getting ready, walking to and from stores, cooking, and whatnot. So she uses an electric wheelchair. People look at her as if she's lazy but never bother to find out the whole story. Just keep things like that in mind when making judgements.
    Maybe that woman in the pic isn't disabled by her weight and using the chair as a crutch. Maybe a health condition or disability led to weight gain and she lost the ability to walk. That loss led to depression and further weight gain.
    Maybe think about ways to help people instead of just judging them.

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  9. being a double amputee my patience with overweight people riding in electric carts is shall we say .. quite "thin".. I wanna scream you got legs fat lard butt GET UP AND WALK.. I wish I could trade.. even if their legs are chunky lol

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  10. Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment.
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    Power Wheelchair Cost

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    ReplyDelete
  11. Hey, very nice site. I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing.
    POWER WHEELCHAIR

    Keep Posting:)

    ReplyDelete