Medicare one

[Guest guest]

I recall reading an article in " Dynamic Chiropractic " I believe,

regarding the owner of one of those disability scooter manufacturers

suing Medicare. Medicare claimed the manufacturer was guilty of

fraud for selling scooters to individuals covered by Medicare and

billing Medicare for them. Medicare tried stating " medical

necessity " had not been proven prior to billing Medicare, therefore

they were guilty of fraud.

The scooter manufacturer found some pretty hot attorney who dug

through the regulations and found that congress had never given HCFA

or Medicare the legal authority to determine medical necessity, and

therefore could not charge anyone with fraud for that reason and the

manufacturer won the case.

I believe my memory of this is fairly accurate, and since that

ruling I haven't been asked by Medicare to justify any treatment I

have provided to my patients. Someone else may remember this case

and be able to comment on it further and with more detail.

Grice, DC

Albany, OR