Watch for streamlining of claims & new fee schedule determinations
DMEPOS
FOOTHILL RANCH, Calif. (August 6, 2019)—Össur, a global provider of innovative prosthetics and orthopedic technologies, announced that its Empower123 system and the supporting servers, firewalls, databases and administrator workstations have earned Certified status for information security by HITRUST.
WASHINGTON, D.C. (May 21, 2019)—The Centers for Medicare & Medicaid Services (CMS) has added a fourth webcast to its education program by splitting the previously announced “Registering and Submitting a Bid” session into two parts. The following webcasts are part of the series designed to assist bidders and sureties on key components of the Round 2021 process:
WASHINGTON, D.C. (April 2, 2019)—AAHomecare has partnered with other leading home medical equipment (HME) stakeholders to develop comprehensive online educational resources to help suppliers understand the rules and requirements for competitive bidding (CB) Round 2021, which can be found at dmecbpeducation.com.
PENNSYLVANIA and DELAWARE—PAMS, the trade association representing durable medical equipment, prosthetic, orthotic and supplies (DMEPOS) suppliers in Pennsylvania and Delaware, announces two upcoming events: “Compliance in the Competition Gap,” Jan. 16, and the PAMS 2019 Billing Seminar, scheduled for Feb. 20.
OWINGS MILLS, Md. (December 12, 2018)—The Board of Certification/Accreditation (BOC) is pleased to announce James “Jim” L. Hewlett, BOCO as the 2018 recipient of the Jim Newberry Award for Extraordinary Service. Hewlett was nominated by Newberry’s widow, Lynne, who describes Hewlett as “one of the most qualified, generous and patient teachers I ever have been blessed to observe.”
CARY, N.C. (December 6, 2018)—Accreditation Commission for Health Care (ACHC) has announced a new partnership with Imark Billing that allows Imark Billing customers to receive special pricing on ACHC’s home health, hospice and private duty accreditation services, as well as discounts on Accreditation University (AU) educational resources that help prepare association members for ACHC accreditation.
Recent report recommends extending and renewing current programs.
By Kristin Easterling
(May 24, 2018)—Recently, the Government Accountability Office (GAO) conducted a study on Medicare prior authorization requirements. The requirements began in seven states for certain power mobility devices such as power wheelchairs in 2012. The categories later expanded to include DME, home health and others.
WATERLOO, Iowa (May 2, 2018)—VGM Group, Inc. announced today the official release of its latest playbook, Industry Insights: How to Capitalize on Opportunities in Post-Acute Health.
This is the second edition in a series that the membership service organization has created for stakeholders in the DMEPOS industry to download and use to adjust to an ever-changing business climate.
CMS updates guidance for providers, and RACs halt audits in storm affected areas.
—Via AAHomecare, WASHINGTON, D.C.
AAHomecare also working with agency as attention shifts to Irma.
WASHINGTON, D.C. (September 7, 2017)—CMS has just released guidance covering replacements for lost/damaged DMEPOS items in the wake of a declared emergency.
—Via AAHomecare—WASHINGTON, D.C. (August 16, 2017)—Last year, CMS finalized the rule to move forward with expanding the prior authorization (PA) program. Although the program has great support from the industry, AAHomecare expressed concern with the lack of physician involvement in the correspondence of the PA decision. Unlike the PMD Demonstration, under the PA expansion, DME MACs cannot automatically communicate with referring physicians on the PA decision.
WASHINGTON, D.C. (August 16, 2017)—Last month, CMS published the annual Medicare Fee-For-Service Improper Payments Report. CMS reports that for dates of service between July 2014–June 2015, the error rate for DMEPOS was 46 percent, which is an increase of 7 percent from the previous year. For the report, 10,999 DMEPOS claims were reviewed. However, CMS states that the majority of this rate is attributed to insufficient documentation and not due to medical necessity.
Rates apply for July 1 through December 31, 2016
WASHINGTON, D.C. (July 7, 2017)—TRICARE is issuing its first official acknowledgements that they will reprocess claims from July 1 through December 31, 2016 to reflect adjustments to the fee schedule mandated by last December’s CURES bill.
New legislation builds upon previous prior authorization legislation.
Via AAHomecare—WASHINGTON, D.C. (May 17, 2017)—We have just received confirmation that Congresswoman Marsha Blackburn (R-Tenn.) has formally introduced legislation that would require prior authorization for certain home medical equipment items in higher price ranges. The formal title for HR 2445 will be the DMEPOS Access and Transparency Act of 2017, and may also be referred to as the DATA Act of 2017.
LENEXA, Kan. (March 9, 2017)—Mediware Information Systems, Inc. is hosting a free webinar for attendees on Tuesday, April 4, 2017, at 1:00 Central, 2:00 EST, to learn how the new Trump administration may impact DME providers and the current competitive bidding program.
Billing errors can result in audits and repayment of claims by the provider to Medicare
New administration will have opportunity to review program prior to moving forward.
WASHINGTON, D.C. (February 8, 2017)—The Centers for Medicare & Medicaid Services (CMS) has decided to temporarily delay moving forward with the next steps of the Round 2019 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program to allow the new administration further opportunity to review the program.
ATLANTA (September 15, 2016)—Friends of Disabled Adults and Children (FODAC) is supporting disaster relief efforts in Louisiana, working with its local contacts (particularly in Baton Rouge and Livingston parishes, two of the worst-hit areas) to contribute funding, equipment and other supplies.
WASHINGTON, D.C. (June 29, 2016)—On June 24, CMS issued a proposed rule that would update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2017. This rule also proposes new quality measures to improve the quality of care by dialysis facilities treating patients with end-stage renal disease.