Anti-Fraud Bill Floated in Senate

FAST Act would target power chairs for pre-pay review; could be expanded to more DME.

Sens. Tom Carper (D-Del.) and Tom Coburn (R-Okla.) have introduced a bill into the Senate, S. 1251, called the Medicare and Medicaid Fighting Fraud and Abuse to Save Taxpayers' Dollars Act (The FAST Act), which aims to require prior authorization for all “high risk” Medicare and Medicaid claims.

The bill points out power wheelchairs as particularly prone to fraud, but the bill’s language is open to interpretation that could prove even more worrying to HME providers.

Section 204 of the bill states that procedures would need to be established “for prepayment review, which may include pre-certification, for all claims for reimbursement under this title for durable medical equipment at high risk of waste,  fraud, and abuse, as determined by the Secretary, including power wheelchairs.’’

This could mean pre-payment reviews for a much broader set of DME than just power chairs, the American Association for Homecare noted in a public statement, adding that it is continuing to review the bill.

Including the bill’s two chief backers, the bill current has seven co-sponsors.

About the Author

David Kopf is the Editor of HME Business.

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