Contact:
Lynn Gonzales
Media Relations
The SCOOTER Store
(830)626-4064
Press Releases
ACTION ON TWO FRONTS:
THE SCOOTER STORE FILES SUIT AGAINST CENTER FOR MEDICARE & MEDICAID SERVICES (CMS) AND SEEKS TO DISMISS GOVERNMENT COUNTERCLAIMS IN SEPARATE LITIGATION
SAN ANTONIO, Texas, June 1, 2005—The SCOOTER Store, the country's largest supplier of power mobility products, today responded to counterclaims filed on April 29th by the Department of Justice on behalf of the Center for Medicare & Medicaid Services (CMS). Last night's filing follows on the heels of a separate suit filed on May 27th by The SCOOTER Store seeking payment from Medicare for power mobility equipment delivered to the program's beneficiaries.
In the May 27 complaint, The SCOOTER Store contends that CMS continues to wrongly deny valid reimbursement claims submitted in compliance with physicians orders. The SCOOTER Store contends that claims should be paid because prior to submitting any Medicare claim The SCOOTER Store received a Congressionally-approved Certificate of Medical Necessity (CMN) from the patient's treating physician. The treating physician completed and signed the CMN and certified the accuracy of the information subject to penalty of law.
"The government should pay the claims that The SCOOTER Store properly submitted," stated The SCOOTER Store President Mike Pfister. "We have followed the law and physicians' orders, and government contractors seem to keep creating reasons to deny claims. As our complaint shows, even officials within CMS have admitted that they have violated the law as a result of their effort to drive down utilization of the power mobility benefit."
The complaint alleges that CMS contractors have demanded that The SCOOTER Store and other suppliers routinely and regularly supply them with volumes of information in addition to the CMN, in violation of HHS's own policies and the laws governing the Medicare program. Additionally, the complaint references internal CMS communications that show that government contractors had, for a number of years, been applying unapproved review criteria to claims in violation of the Paperwork Reduction Act.
"The Congressionally-approved Certificate of Medical Necessity was supposed to avoid confusion and bring integrity to the Medicare program. Unfortunately, CMS's present approach is having the opposite effect," stated Pfister.
In a separate action, The SCOOTER Store has also filed a "motion to dismiss" recent counterclaims filed by the Department of Justice in pending litigation, arguing that the counterclaims admit that reimbursement claims filed by The SCOOTER Store included all legally-required paperwork and physician certifications. According to the motion, the counterclaims fail to make any argument that supports the claim that The SCOOTER Store violated the False Claims Act, instead offering "conclusory allegations or legal conclusions masquerading as factual conclusions."
"These counterclaims are a smoke-screen to cover-up the government's own unlawful behavior," said Pfister, "Furthermore, the arguments made by the government actually prove that The SCOOTER Store has acted lawfully and in the best interest of Medicare beneficiaries, because the government admits that all of our claims were submitted based upon the certified conclusions reached by treating physicians. The SCOOTER Store has complied with the law, provided equipment in accordance with physician orders, and tried to navigate the confusing set of demands being issued by government contractors. The government's allegations are baseless and without merit."
The SCOOTER Store is the nation's largest supplier of power mobility equipment. The SCOOTER Store has worked with over 92,000 different physicians and has provided power mobility products to over 205,000 disabled seniors. The company has over 70 locations in 42 states and provides in home service calls to over 6,000 beneficiaries per month. The SCOOTER Store's commitment to ethical and legal business practices resulted in recent third-party accreditation from the Accreditation Commission for Health Care, Inc.
About The SCOOTER Store
Since 1991, The SCOOTER Store has helped provide freedom and independence to more than 350,000 people with limited mobility. The SCOOTER Store offers a full line of durable medical equipment, including power wheelchairs and scooters, lifts, ramps and accessories in all 48 contiguous states plus Puerto Rico. The SCOOTER Store has worked with more than 110,000 physicians, providing expertise and quality service to their patients, and is accredited by the Accreditation Commission for Health Care.
