WASHINGTON, D.C. (May 31, 2019)—The Centers for Medicare & Medicaid Services (CMS) will be hosting two Special Open Door Forums (ODF) on June 4 and June 12, 2019. Prior Authorization On...
WASHINGTON, (April 18, 2019)—The Centers for Medicare & Medicaid Services (CMS) has selected 12 additional items of Durable Medical Equipment (DME) to be subject to required prior...
Opinion: Simplify Medicare’s Overly Complex Auditing Process for Home Respiratory Care
Reimbursements withheld due to physician errors harm oxygen providers
How to Build Revenue with Sleep
Cape Medical Supply President and CEO Gary Sheehan on what makes sleep therapy his company’s No. 1 revenue stream
(June 27, 2018)—The Integrated Care Resource Center (ICRC) recently released a briefing titled “Facilitating Access to Medicaid Durable Medical Equipment for Dually Eligible Beneficiaries in the...
WASHINGTON, D.C. (June 4, 2018)—On Friday, June 1, 2018, CMS released CMS-6080-N, “Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics,...
How to Ensure Ethical Business Practices
The tools for detecting problems before the bubble up
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...
—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...
DMEPOS Access and Transparency Act of 2017
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...
WASHINGTON, D.C. (June 9, 2016)—The Partnership for Quality Home Healthcare—a coalition of home health providers dedicated to improving the integrity, quality and efficiency of home health care...
WASHINGTON, D.C. (May 13, 2016)—The Partnership for Quality Home Healthcare—a coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home health care...
Medicare “Hospital Star Rating” May Correspond to Patient Outcomes The Centers for Medicare and Medicaid Services has been letting patients grade their hospital experiences, and those “patient...
Authorization and Eligibility
Recently I received a call from an insurance specialist at the imaging center where I will be having an MRI soon. The purpose of the call was not to remind me about my appointment, but to inform me...
WASHINGTON, D.C. (January 7, 2016)—On December 29, 2015, CMS published the final rule to Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics,...