DALLAS--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 said.

"CMS has noted significant changes because of our efforts to curtail wheelchair fraud in Harris County," said 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 noted.

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.

While Lathrop said the current number of claims for power wheelchairs was not "readily available," she cited 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.
--As of Feb. 26, 2004 (when the National Supplier Clearinghouse completed site visits in the area), supplier numbers for 355 Harris County companies had been revoked.

Lathrop added that "CMS definitely believes that Operation Wheeler Dealer was a success." She noted the initiative also gave the agency ammunition to fight fraud in other areas.

"There are a number of activities related to OWD that could be replicated elsewhere, if needed," she said. "These include targeted medical review; on-site visits to suppliers to identify non-existent or out-of-compliance suppliers; and training of suppliers and physicians on medical policies, claims submittal and requirements for the particular products/services."

For more on providers in Harris County, check the upcoming spring issue of HomeCareXtra.