MEDICARE: Orthotics Ruling Has Implications for Beneficiary Access and Federal and State Costs
Abstract
In the late 198Os and early 199Os, the Health Care Financing Administration (HCFA-now called the Centers for Medicare and Medicaid Services or CMS) because some were concerned that some suppliers were improperly billing Medicare for certain items that attach to wheelchairs and other equipment. These suppliers were billing such items using codes for orthotic devices, which include leg, arms, back, and neck braces that provide rigid or semi-rigid support to weak or deformed body parts or restrict or diminate motion in a diseased or injured part of the body. However, other suppliers were billing devices that served essentially the same purpose using codes for durable medical equipment (DME), which is equipment-such as wheelchairs and crutches-that serves a medical purpose, can withstand repeated use, is not generally useful in the absence of an illness or injury, and is appropriate for use in the home.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 2002
- Accession Number
- ADA401975
Entities
Organizations
- United States Government Accountability Office