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Panel probes sharp jump in extra-large wheelchair payments; department pledges audits and review
Summary
Committee questioned an increase in non-emergency medical transport (NEMT) 'XL wheelchair' payments after guidance and Medicare benchmarking pushed a per-trip rate from roughly $232 to $639; the department said audits will increase and it will investigate intentional upcoding, while acknowledging earlier guidance contributed to utilization growth.
Legislators pressed the department to explain how an NEMT transport rate for extra-large wheelchair services rose sharply and why utilization expanded after that change.
OSPB staff and department leaders told the Joint Budget and Technology Committees that the department had provided permissive guidance in 2020 to use an ambulance-rate code for certain transports that required additional equipment or personnel. That guidance was…
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