Then and Now In Harris County

Sixteen months after the cessation of a concentrated effort to crack power wheelchair fraud in Harris County, Texas, CMS is still seeing a decrease in fraudulent claims, officials say.

“CMS has noted significant changes because of our efforts to curtail wheelchair fraud in Harris County,” according to Julia Lathrop, special assistant to the regional administrator for CMS in Dallas. “The number of claims for power wheelchairs dropped significantly, the claims denial rate is more appropriate and a number of wheelchair suppliers' Medicare numbers were revoked for various reasons.”

While Operation Wheeler Dealer officially ended on Oct. 1, 2005, CMS and its contractors still “monitor wheelchair activities in Harris County on a regular basis,” Lathrop notes.

While the number of claims for power wheelchairs is not currently available, Lathrop cites these statistics:

• Submitted charges in 2002, the year before Operation Wheeler Dealer went into effect, added up to $154,774,372; by Oct. 1, 2006, they had dropped to $20,150,712.

• The total number of beneficiaries (billed) also dropped dramatically, from 21,353 in 2002 to 3,354 in 2006.

She notes, too, that some HME providers lost their Medicare supplier numbers: “The National Supplier Clearinghouse completed its site visits to Harris County suppliers on Feb. 26, 2004. As of that date, the NSC had revoked 355 Harris County suppliers.”

Lathrop adds that “CMS definitely believes that Operation Wheeler Dealer was a success.”

The initiative was CMS' response to massive PWC fraud schemes that came to light in Houston, which is located in Harris County. Medicare paid more than 31,000 claims for power chairs in Texas in 2002 compared to 3,000 in 2001, officials said when Wheeler Dealer was launched.

The agency put the 10-point initiative into place in September 2003. Among other things, the plan suspended issuance of new provider numbers; required all payments for motorized wheelchairs in Harris County to be scrutinized and approved by CMS staff on a special task force; required the medical provider to see the patient before prescribing a wheelchair or scooter; and targeted power wheelchairs as the “first item analyzed for potential inherent reasonableness adjustments.”

Harris County HME providers were also required to attend training programs on CMS medical policies.