Medicare Reimbursement

The implementation of competitive bidding and ongoing Medicare cuts and audits have had a devastating impact on many HME providers. As a result of these recent challenges, many HME companies have... Read more >
Those of us involved in various segments of health care know that the landscape is drastically changing and will continue to do so in the years ahead. The ways we have done business in the past may... Read more >
(Jan. 24, 2014)—According to Joint DME MAC A, a new HCPCS code, K0900, has been created for use with custom fabricated durable medical equipment other than wheelchairs. 42 CFR §414.224(a) describes... Read more >
The DME/HME market has experienced a great deal of consolidation due directly to Medicare reimbursement cuts from competitive bidding. Further cuts in 
2014 are expected from managed care/private... Read more >
ATLANTA (Dec. 30, 2013)—Another eventful year has come to a close with so many memorable moments. Distilling the biggest stories of 2013 is a function of hindsight, clicks and reader reaction.... Read more >
SILVER SPRING, Md. (Dec. 19, 2013)—The Food and Drug Administration is looking to shorten the time medical-device manufacturers wait before health plans will pay for products after they're approved.... Read more >
GOODLETTSVILLE, Tenn. (Dec. 3, 2013)—Medicare is taking back more than $200,000 it paid for complex rehabilitation wheelchairs that were delivered to 22 severely disabled Nashville area patients,... Read more >
On Nov. 22, CMS issued the final 2014 home health care payment rule. The final policies in this rule better align Medicare payments with home health agencies’ costs providing care, while lowering... Read more >
Three weeks ago, when I was asked to advise a client on how to apply for an Extended Repayment Plan, I turned to the Medicare Financial Management Manual (MFMM), expecting the same answer as recent... Read more >
BALTIMORE (Oct. 28, 2013)—CMS recently announced a 0.5 percent decrease in the interest rate on Medicare overpayments and underpayments to 10.125 percent. Except for April 17 to July 16 of this year... Read more >
On April 29, 2013, CMS published a proposed rule in the Federal Register to solicit comment on two major issues: changes to the Medicare provider enrollment process and the establishment of a new... Read more >
Capped rental and two rounds of competitive bidding have dramatically lowered the fee schedule for power wheelchairs to the detriment of providers who build their business around Medicare—and... Read more >
In an effort to keep pace in the dynamic DMEPOS industry, suppliers must regularly recalibrate their business plans and operations to address the increasing challenges of supplying patients with... Read more >
I’m often asked about how to avoid a Medicare audit. There is only one response I can think of, and that is to quit billing Medicare. Since that’s not a reasonable response, I suggest... Read more >