[Alpha]

This question was posed to me, and I'm not sure of the answer. If a patient has a power chair, purchased by Medicare, will they cover a wheeled walker for use in the home? Thanks for your help!!!

[DMEisgoodfun]

Medicare will pay for the least costly equipment they can use in the home.
Because they already have pov, you'll want chart notes about the walker. In
these cases we also tell the client that because they CAN use a walker in
the home, that means they no longer qualify for the pwr chair so any future
repairs, replacement parts would likely be at their own expense. Then we
document document document so we're not on the hook down the line when they
bring the pov back to us for batteries.

Just a side note, a few months ago I appealed a denial for a wheelchair that
denied because they had a pov. We went to ALJ level and the Medicare
Director contracted with Medicare actually called in to state they
beneficiaries DO NOT improve to the point where they need less expensive
equipment. We won but I thought it was an interesting stance Medicare was
taking.

[Regina]

I recently spoke to someone at Medicare who stated the same thing- Medicare's position is that they will not pay for any lower level equipment after they have covered a POV.

[SimplyLori]

We get patient's that sadly misrepresented their needs to get their PMDs covered by MCR (most often through large national companies). We won't bill anything assigned once we find that out and I personally am fairly blunt about why.

[Regina]

We got burned so many times before the same and similar option was available on the IVR, because people conveniently "forgot" to tell us about the power chair. Plus, as Lori states, I think people seriously misrepresent their conditions to get them in the first place. The biggest complaint that we hear from patients who want manual wheelchairs after they get a POV is that they can't use it in their home. Oh well. But you can visit the Grand Canyon!

[Lorna]

I agree with being blunt. Medicare has made it all to easy for the bigger power chair and diabetic companies to do whatever they want.