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Mary Ellen Buning from RESNA, put
together
a fabulous resource for combating the shady practices of companies like the
Scooter Store and others, who try to put our folks with ALS and progressive
disorders in bad power chairs (and use up their benefits). See below.
Thanks,
Amber Ward Amber L. Ward,
OTR/L,
ATP Hello
everyone, I have gotten very
frustrated by clients who come in for wheelchair seating and mobility eval
(due
to pain or pressure ulcer or inability to drive) but have recently used
their
Medicare power mobility device benefit at the Scooter Store… e.g., a
guy
with SCI sitting on Captains Seating, a guy with Parkinson’s and
scoliosis on captains seating with no programmable electronics to
compensate
for tremor, and a guy with a neuro diagnosis in pain because he cannot
independently change his position or weight shift. I am presuming that
others
of you are having problems too, so I decided to share what I learned in the
process of trying to make things right for my
clients. Laura Cohen told me
that
the Scooter Store is now under a 5 year Office of the Inspector General
ordered
“Corporate Integrity Agreement” as a result of reported
problems.
This Corporate Integrity Agreement (CIA) means they won the right to
continue
to bill Medicare for power mobility devices (PMDs) but must follow some
prescribed steps and toe the line as exemplary providers of
PMDs. Interestingly, there
is NO
information about this on their corporate website. http://www.thescooterstore.com/ I called and talked to
a
“customer advocate” (one of 15) named Lisa at the Scooter Store
at
800-391-7237. I asked about filing a
complaint and she stated that she had no knowledge of a compliance officer
(this is a requirement of a CIA!) She said that a formal
complaint should be faxed or mailed to: 866.407.1599 Or mailed
to: The Scooter
Store Attention: Advocate
(Lisa) Since the Scooter
Store is
accredited by the Accreditation Commission for Health Care, Inc (ACHC),
they
have a complaint process for business that do not uphold their standards.
This
organization represents companies that “pledge to a code of
ethics”
so it makes sense that they should get a copy of a complaint
too. The Agency website
is: http://www.achc.org/ A link to the ACHC
complaint process for filing a complaint: http://www.achc.org/public_complaint_accredited_org.php They have a form that
will
be very helpful in filling out your complaint to the Scooter Store, In
fact, I
think their form could be used very nicely to file a complaint with the
Scooter
Store. http://www.achc.org/docs/ACHC%20Complaint%20Intake%20Form.pdf Your complaint should
definitely include the statement that the person’s Medicare benefit
was
used to purchase an inappropriate PMD and that having used this benefit the
person is now unable to get an appropriate PMD. It should also include a
paragraph that explains why the provided PMD is inappropriate for the
person
(e.g., because of scoliosis or need for postural support or risk of
pressure
ulcers), or tilt in space, or programmable electronics. It would be good to
include a statement that a knowledgeable, professional, ethical provider
would
have recognized that the customer's diagnosis should have pointed to the
need
for an expert evaluation or a more complex PMD that would have allowed for
upgrades or modifications in the future or included features appropriate to
the
diagnosis. Fax the ACHC
form
to: (919) 785-3011 Or
mail: Accreditation
Commission
for Health Care, Inc. 4700 Falls of
E-mail: xxxxxx@xxxxxxxx
(919) 785-1214
voice Finally, fax a copy of
this form to the Office of the Inspector General in the Department of
Health
and Human Services. The hotline for
reporting
fraud and abuse is: Phone:
866-893-9622 Send the complaint as
a
Fax to: 202-619-1381 On your fax write, Attention: HHS-OIG Hotline
Attention
Operator 19 E-Mail:
xxxxxx@xxxxxxxxxxx Mail: Office of Inspector
General Department of Health
and
Human Services Attn:
HOTLINE There is a list of all
the
health care businesses that are currently under Corporate Integrity
Agreements
at http://www.oig.hhs.gov/fraud/cia/cia_list.asp Hope this gives you
some
impetus to plow through the process too. Mary
Ellen ----- Mary Ellen Buning,
PhD,
OTR/L, ATP Assistive Frazier Rehabilitation
Institute Email:
xxxxxx@xxxxxxxxx Phone: 502.407.3272
Fax:
502.582.7403
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