By Mark Lisheron | Watchdog.org
AUSTIN – Contrary to those uplifting commercials featuring senior citizens tooling around on powered wheelchairs, their independence and dignity restored, this might not be Medicare in America at its best.
More than 100 FBI agents and federal and state agency investigators Wednesday descended on the New Braunfels, Texas, headquarters of the Scooter Store. The company, which has been in and out of trouble for at least the past eight years, is one of the nation’s leading purveyors of powered wheelchairs paid for largely through Medicare.
Investigators declined to discuss the contents of the sealed search warrants they brought with them. Reporters on the scene said agents interviewed Scooter Store employees who work on Medicare billing.
Those employees declined to discuss the questioning. The rest of the store staff were sent home by agents who handed them cards soliciting their help with a toll-free number for the FBI.
Wednesday’s raid is part of an intensifying hunt for Medicare and Medicaid fraud in Texas. The Senate Health and Human Services Committee earlier this week gave its approval to Senate Bill 8 providing broad support for a crackdown on Medicaid fraud.
The Scooter Store has for years advertised its prowess in navigating Medicare provisions on behalf of seniors to provide them with a motorized wheelchair at little or no out-of-pocket costs to them.
These promises were irresistible. In 1999 American taxpayers subsidized $259 million for power wheelchairs, according to an investigation done in 2011 by the Department of Health and Human Services’ inspector general. By 2003, power chair subsidies jumped to $1.2 billion.
After a tightening of Medicare guidelines for eligibility by the Centers for Medicare and Medicaid Services, taxpayer subsidies dropped to $658 million by 2007 but shot up the following year to $779 million, the report said.
The inspector general concluded that 61 percent, $95 million worth of all power wheelchair claims reviewed in the first six months of 2007 were faulty. In 9 percent of the cases the wheelchairs were not medically necessary and in 52 percent because the medical necessity had not been documented, the report said.
A later inspector general’s audit determined the Scooter Store had between 2009 and 2011 been overpaid by Medicare between $46.8 million and $87.7 million. The company negotiated with the Centers for Medicare and Medicaid Services for a settlement with the government of just $19.5 million, according to an investigative report last month by CBS News.
In 2007, the U.S. Department of Justice ordered the Scooter Store to pay back $4 million and relinquish millions of dollars in claims for falsely representing the medical necessity for the wheelchairs to doctors.
At the time the company was getting $5,000 to $7,000 per chair from Medicare, then selling them for $1,500 to $2,000 each, the Justice Department said.