Unrestricted National Medicare Fraud Alert (UMFA 9802, issued June 9, 1998) REVISED October 6, 1998(Revisions are Shown in Italics): Billing for Services Not Rendered or Not Medically Necessary; Upcoding (Billing for Powered Wheelchairs and Delivering Power Operated Vehicles (POVs)); and Exchanging Power Wheelchairs for POVs After the Wheelchairs Were Paid.
DME companies are utilizing three mechanisms to obtain inappropriate reimbursement for power vehicles, primarily for beneficiaries in Florida. The three mechanisms are:
1. They (the DME companies) bill for services not rendered or not medically necessary; or
2. They deliver a POV (scooter) and bill for a power wheelchair; or
3. They deliver and bill for a power wheelchair, and after receiving payment go back to the beneficiary and exchange it for a POV.
The primary AK@ codes appearing were - K0011, K0021, K0031, K0034, K0067, K0073, K0081, and K0086. All these codes appeared in the beneficiari...