CMS

BOSTON – The owner of Conclave Media (Conclave) and Nationwide Health Advocates (Nationwide) has been charged and has agreed to plead guilty in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces and genetic tests. 

Reps. Terry Sewell (D-AL) and Adrian Smith (R-NE) are leading an effort to help maintain strong access to home oxygen for individuals with respiratory challenges.

BOSTON—Senator Edward J.

PurposeCare, a provider of coordinated homecare and home health services in the Midwest, announced its acquisition of three Midwest homecare agencies in the Indiana and Ohio markets.

DALLAS—Homecare Homebase (HCHB), a software for home-based care, has released an updated HCHB Analytics Home Health Impact Report Model, less than two weeks following the Centers for Medicare & Medicaid Services (CMS) publication of the 2024 Home Health Proposed Rule. The tool helps customers quickly and accurately identify the potential impact of proposed and final Medicare reimbursement changes on their unique agencies.

WASHINGTON—The Centers for Medicare & Medicaid’s (CMS) proposed rate reductions for home health could be devastating for agencies if they are codified, said Bill Dombi, president of the National Association for Home Care & Hospice (NAHC). Even worse, CMS has left a door open to demand some $3 billion in clawbacks for prior years of what it interprets as over-payments.  

Broader Medicare coverage is now available for Biogen and Eisai’s Leqembi (the brand name for lecanemab) following the Food and Drug Administration’s (FDA) move to grant traditional approval to the drug that treats individuals with Alzheimer’s disease. The Centers for Medicare & Medicaid Services had previously announced this would be the case and released more details on coverage.

WASHINGTON—The Center for Medicare & Medicaid Services' proposed 2024 rule for the home health payment system includes a slew of hospice-specific provisions, many of them designed to reduce fraud and so-called "hospice flipping." Here's a look at what's included, according to the National Association for Homecare and Hospice. 

BOSTON—Myomo, Inc. (NYSE American: MYO), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, announced that its request to the Centers for Medicare and Medicaid Services (CMS) to classify the company’s MyoPro as a brace has been published for public comment.

NEWARK, New Jersey—An Ocean County, New Jersey, man admitted his role in a durable medical equipment (DME) kickback scheme, U.S. Attorney Philip R. Sellinger announced.

Alexander Schleider, 57, of Lakewood, New Jersey, pleaded guilty before U.S. District Judge Michael A. Shipp in Trenton federal court to an information charging him with one count of conspiracy to commit health care fraud and one count of wire fraud.

Washington, D.C.—The National Association for Home Care and Hospice (NAHC) filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) and the United States Department of Health and Human Services (HHS) challenging the validity of a change in Medicare home health payment that reduced rates by 3.925% in 2023 with significant additio

LOS ANGELES—A South Bay woman was found guilty on Tuesday, June 27 of nearly two dozen felonies for billing Medicare more than $24 million by submitting fraudulent claims for medically unnecessary durable medical equipment—mostly power wheelchairs (PWC)—and PWC repairs, many of which were never performed.

The National Association for Home Care & Hospice (NAHC) and the Partnership for Quality Home Healthcare (the Partnership) commended Senators Debbie Stabenow (D-MI) and Susan Collins (R-ME) for introducing the Preserving Access to Home Health Act of 2023 to safeguard access to essential home-based, clinically advanced health care services by preventing the Centers for Medicare & Medicaid Services (CMS) from implementing dire cuts of negative -7.85% to the Medicare Home Health

NEWTOWN, Pennsylvania—Helius Medical Technologies, Inc., a neurotech company focused on delivering a novel therapeutic neuromodulation approach for balance and gait deficits, announced its Portable Neuromodulation Stimulator (PoNS) device has been awarded durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) accreditation by The Compliance Team (TCT), which is authorized by the Centers for Medicare & Medicaid Services (CMS) to accredit all DMEPOS products and services.

In a newsletter, AAHomecare (AAHC) announced it and the ALS Association met with the Centers for Medicare & Medicaid Services (CMS) Part C leadership to share concerns about ongoing authorization challenges for medically necessary non-invasive ventilator (NIV) devices by Medicare Advantage (MA) payers. Access to these ventilator systems is especially important for individuals with significant neuromuscular diseases such as ALS.

The Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary released projections of National Health Expenditures (NHE) and health insurance enrollment for the years 2022-2031.

HOUSTON—A 47-year-old home health company owner has been ordered to prison following his conviction of conspiracy to commit health care fraud, announced U.S. Attorney Alamdar S. Hamdani.

Akintunde Oyewale, Richmond, pleaded guilty Feb. 1, 2022.

Damian Williams, the United States Attorney for the Southern District of New York, announced that Christopher Margait was sentenced to 65 months in prison for conspiracy to commit health care fraud by fraudulently trafficking in orders for durable medical equipment (DME) such as back, knee, and wrist braces. Margait previously pled guilty to the charge and was sentenced before United States District Judge Denise Cote.

MOORESTOWN, New Jersey—Tabula Rasa HealthCare, Inc. (TRHC), a health care company advancing personalized, comprehensive care for value-based care organizations, announced Mountain Empire PACE, a Program of All-Inclusive Care for the Elderly (PACE) in rural Virginia, signed agreements with TRHC for personalized pharmacy services and pharmacy benefit management, expanding their existing partnership.

WASHINGTON—Calling it a "landmark decision," the Centers for Medicare & Medicaid Services (CMS) announced May 16, 2023 that it had, for the first time, made power seat elevation for power wheelchairs eligible for reimbursement as durable medical equipment (DME).