In order to receive a home health care device a person who has Medicare just needs a doctor's order and they can get it from a supplier immediately. The system works well for all involved unless fraud is used to gain patient and doctor identifications and false claims are filed and paid.
In response, Medicare has been testing a pilot program in 19 states. In those states before a Medicare patient can receive a power wheelchair the doctor must first get approval from Medicare. How has the pilot program worked? Beginning on Feb. 28, the preapproval process will be expanded nationally. It will include other common home health devices, including oxygen and sleep apnea equipment.
The Pittsburgh Post-Gazette reported this story in "Medicare to tighten requirements for many home medical devices."
While it is good that Medicare is looking for ways to eliminate fraud, these new restrictions could have a negative impact on patients' health care. Some experts fear that requiring preapproval could lead to increased hospital stays while approval is sought but Medicare claims it can respond to requests within 10 days. Medicare also plans to have a system in place to expedite review when necessary.
Reference: Pittsburgh Post-Gazette (Jan. 18, 2016) "Medicare to tighten requirements for many home medical devices."