Performance Improvement 2009. Do Medicare Fee Schedule Amounts for Power Wheelchairs Exceed Internet Prices?


This study compared the Medicare fee schedule amounts for power wheelchairs to Internet prices. In 2004, Medicare and its beneficiaries paid higher prices for power wheelchairs than consumers or suppliers. In November 2006, the agency implemented a revised fee schedule for power wheelchairs as part of a strategy to reform Medicare payments for power wheelchairs. The revised fee schedule was designed to improve the accuracy of Medicare pricing for power wheelchairs. Reviewers (1) collected and analyzed prices of power wheelchairs from the Internet sites of power wheelchair suppliers during the first quarter of 2007, (2) then compared the median Internet prices of power wheelchairs to the Medicare fee schedule amounts during the same time period, and (3) calculated the potential savings to Medicare and its beneficiaries during the first quarter of 2007 had power wheelchair claims submitted to Medicare been reimbursed at the median Internet prices we collected.

Reviewers found that Medicare fee schedule amounts for power wheelchairs were 45 percent higher than median Internet prices in the first quarter of calendar year 2007. Medicare and its beneficiaries could have achieved savings during the first quarter of 2007 had power wheelchairs been reimbursed at median Internet prices. On average, each beneficiary could have saved $233 of his or her power wheelchair copayment. Researchers concluded that consumers were able to purchase most power wheelchairs over the Internet at lower prices than the Medicare fee schedule amounts for the same power wheelchairs.

Report Title: A Comparison of Medicare Program and Consumer Internet Prices for Power Wheelchairs
Agency Sponsor: OS-OIG, Office of Inspector General
Federal Contact: Erin Lemire, 202-205-9523
Performer: Staff; Office of Inspector General
PIC ID: 8991

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