WASHINGTON, D.C. (February 7, 2020)—The Recovery Audit Contractor (RAC) has been approved to audit hospital beds and manual wheelchairs.
medical necessity
A look at CMS’s recommendations for providers
WASHINGTON, D.C. (April 5, 2019)—Last week, the Government Accountability Office (GAO) published a report titled, “Medicare And Medicaid CMS Should Assess Documentation Necessary to Identify Improper Payments.” For the report, the GAO examined the portion of the improper payment rates for Medicare and Medicaid programs that are attributed to insufficient documentation.
Effective date of August 1 give providers time to adapt.
WASHINGTON, D.C. (May 14, 2018)—Effective August 1, 2018, the Centers for Medicare & Medicaid Services (CMS) will require suppliers to use KX, GA, GY and GZ modifiers on oxygen claims. The KX modifier will indicate when payment criteria is met, and the GA, GY and GZ modifiers provide more information for oxygen claims that do not meet payment criteria.
Restoring dignity to those who experience hair loss can help with the healing process.
WATERLOO, Iowa (June 27, 2017)—Last week Rep. Jim McGovern (D-Mass.) introduced a bill that would provide coverage for wigs to Medicare beneficiaries. The bill, HR 2925 would allow wigs to be covered as durable medical equipment; opening access for Medicare beneficiaries that a dermatologist, oncologist or attending physician can certify medical necessity as a part of rehabilitative treatment.
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.
—Via AAHomecare WASHINGTON, D.C. (August 10, 2016)—Last week, CMS announced that medical necessity no longer has to be met for replacement of essential accessories for a beneficiary-owned CPAP device or RAD. CMS and CMS contractors will now assume that beneficiary-owned CPAP devices and RADs have met their medical necessity requirements through the 13-month continuous usage.
WATERLOO, Iowa, Feb. 20, 2013—HQAA has launched the first accreditation program specifically for facility-based ventilator care unit (FBVU) providers. “FBVU accreditation sets your ventilator unit apart from the competition,” according to Steve DeGenaro, RRT, Director of Survey Services at HQAA. “HQAA’s quality check shows your commitment to providing the best patient care.”
An AAHomecare "Mobility Matters" article counters "misperceptions in the recent OIG report on power wheelchair documentation."
The data is from 2007 and the trouble rests with physician education, HME advocates say, but will government officials care about that?