 Compliance: Current Compliance/Reimbursement Issues- DMEPOS Enrollment vs. Accreditation
Is There a Difference? - HHS Fights DME Fraud in South Florida, Southern California
- CMS Issues Final Rule Prohibiting Physician Self-Referral
- NPI “Contingency Plan” Announced
- CMS Developing Competitive Bidding Implementation Website
- CMS Taking Public Comments on Revised ABN
- Invacare restructures to increase efficiency
HME News - NUCC Releases Updates to the Health Care Provider Taxonomy Code Set
- Capped Rental & Supplier Standard #5 Information
- DRA COMPLIANCE: CMS ISSUES DECEMBER 13, 2006 GUIDANCE
- SCOOTER STORE LAYS OFF 200 EMPLOYEES
HME NewsWire - CIRCUIT COURT: CMS HAD RIGHT TO REQUEST INFO BEYOND CMN
HME NewsWire - Study Predicts Wheelchair Cuts in Medicare Will Trigger Exodus of Providers and Sharply Reduce Patient Access
AAHomecare Study Says Wheelchair Cuts Will Increase Government Costs by Billions of Dollars - Important Information Regarding Competitive Bidding and the Supplier Information Listed with the NSC
- National Supplier Clearinghouse – NPI & CMS855S Update
- FBI ACCUSES DIABETIC SHOEMAKER OF FRAUD
- Mobility Industry Predicts Dire Circumstances if Medicare Proceeds with Pay Cuts for Power Wheelchairs
On Nov.15 Medicare will reduce reimbursements for power wheelchairs by about an average of 35% - Medicare Issues Revised Local Coverage Determinations (LCD) for Power Mobility Devices
- Region A/B DME PSC Bulletin
- MEDICARE ENHANCES QUALITY IMPROVEMENT ORGANIZATION PROGRAM OVERSIGHT
- CMS Issues Final Standards For Suppliers
- FINAL RULE ON ACCREDITATION OF DME SUPPLIERS RELEASED
314 page document also includes PPS rule; VGM offers "DME only" condensed version - Revisit security rule compliance in your HME facility
- Wheelchair CMNs - New Instructions
- CMS Issues Final Provider/Supplier Enrollment Rule
June 2006 - Mobility Stakeholders: Code Descriptions Look Good, but Testing Requirement Worrisome
HomeCare Monday - Overview of the DMEPOS Reenrollment Process
Suppliers must enroll every three years - National Provider Identifier (NPI) Countdown
- House Letter Asks CMS to Re-Evaluate PMD Rule
HomeCare Monday - Information on NPI and the Revised CMS 855 Medicare Provider Enrollment Applications
- The Revised CMS 855S - Specific Changes for DMEPOS Suppliers
May 1, 2006 - Appeals Process and Filing Criteria Update
- Revised Local Coverage Determination for Nebulizers
AAHomecare Comments - Information Suppliers Should be Aware of Regarding the NPI and the Revised CMS 855S
- CMS Announces Efforts to Streamline and Improve the Medicare Enrollment Process
- CMS FINALIZES PWC RULE, INDUSTRY SEEKS CLARIFICATION
April 5, 2006 - DME MACs Prepare for Start-Up
- Q & A about Provisions from Budget Bill that Affect Capped Rental HME and Home Oxygen
- Change Payment Floor Date for Paper Claims
Effective January 1, 2006 - Payment Provisions in the Original Medicare Program Immediately Affected by the Deficit Reduction Act
2006 Fact Sheet - Bye Bye DMERCs, Hello MACs
By Denise M. Fletcher, JD - Technical Committee Begins Work on New PMD Codes
- Q & A about Provisions from Budget Bill that Affect Capped Rental HME and Home Oxygen
- AAHomecare Not Surprised but Disappointed with Final Rule on Ventilators, NPPVs
- HIPAA Security Nightmare: Thief steals data for 365,000 patients from car
- BIPAP CAP
- CMS revises payment classification for RADs
- CMS Reclassifies Some Respiratory Assist Devices
- CMS REVISES PAYMENT CLASSIFICATION OF CERTAIN RESPIRATORY ASSIST DEVICES
Bi-level with backup now capped - Nebulizer Drugs: Albuterol and Ipratropium
January 1, 2006 - DuoNeb - Inherent Reasonableness (IR) Final Rule
- DOT Rules Could Limit Driver Hours
- CMS Issues Clarification on Inhalation Drug Dispensing Fee
- Senate, House debate cap rental option for DME
HME News - Lawmakers delay decision on key PWC provision
HME News - Comment period closes for PWC rule
- Cap rental proposals `catastrophic` for providers, beneficiaries
HME News - Committee drops PWC reimbursement cut
- CMS forum address PWC billing, provider satisfaction
- DMERCs Implement Grace Period for Power Mobility Rule
- Dispensing fee implosion: An industry mulls its options
HME News - AAHomecare Disputes Dispensing Fee Cut for Home Inhalation Drug Therapy
- OIG Oxygen Survey Could Build Case for Reimbursement Cuts
AAHomecare - Feds continue to roll over fraud
Health Care Fraud and Abuse Control Program Update - Docs to see Medicare cuts in 2006
- MMA - Evidence of Medical Necessity: Power Wheelchair and Power Operated Vehicle (POV)/Power Mobility Device (PMD) Claims
Implementation occurs on October 25, 2005. - MMA - New G Code for Power Mobility Devices (PMDs)
- Bachenheimer: "What are they smoking?"
Mobility Issue Update From Medtrade (Transcript) - SADMERC Medical Director: Power Chair Coding Is Job One
HomeCare Monday - CMS delays implementing new PWC codes
- Status of Activities Related to Power Mobility Devices (PMDs)
October 14, 2005 - WHEELCHAIR CMN TRANSITION CONFERENCE CALL FOR
- Mobility Advocates Descend on Washington to Request Time to Implement New Policies
- Inhalation Dispensing Fee Issues
AAHomecare - Mobility Advocates Descend on Washington to Request Time to Implement New Policies
- Power Mobility Devices – Documentation Requirements
On or after October 25, 2005 - The OIG will audit for fraud and abuse in the wake of Hurricane Katrina
- National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
- National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
- AAH, OIG surveys heat up dispensing fee debate
HME NewsWire - Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles
AAHomecare Comments - Nearly Half of Homecare Pharmacies May Stop Providing Inhalation Drug Therapy
AAHomcare Press Release - MMA - Evidence of Medical Necessity: Power Wheelchair and Power Operated Vehicle (POV)/Power Mobility Device (PMD) Claims
Update - Conditions for Payment of Power Mobility Devices, including Power Wheelchairs and Power-Operated Vehicles
AAHomecare Comments - National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
- Power Mobility Devices – Draft LCD – Corrections
(September 14 original release) - CMS Releases Draft of HME Supplier Quality Standards
- URGENT MESSAGE FROM NCART
- Wheelchair CMNs – Transition Instructions
- NEW POWER MOBILITY DEVICE CODES
Testing - Power Mobility Device Draft Local Coverage Determination
Includes Link To Draft Policy - CMS Announces Special Open Door Forum on Power Mobility Devices
- Conference surveys state of LTOT, suggests improvements
HME News - CMS Interim Final Rule, “Conditions for Payment of Power Mobility Devices”
RATC Update - CMS drops CMN for power chairs
HME News - HME industry: loss of CMN is no `happy medium`
HME News - Industry: More Clarity, More Time Needed on Power Mobility Rule
HomeCare Monday - New Regulation on Power Mobility
- Pennsylvania`s Senators Ask CMS for Clarity on Mobility Documentation
- CPAP KX MODIFIER USAGE AND DOCUMENTATION
- CMS proposes to cut neb-med dispensing fee in 2006
HME News - CMS, DMERC officials disagree over PWC policy
HME News - AAHomecare Opposes Any Cut to Dispensing Fee for Home Inhalation Drug Therapy
- Overnight Oximetery Testing
- CMS Says Oximetry Test Units Can Be Delivered to Beneficiaries` Homes
- CMS: HME suppliers may deliver overnight pulse oximetry testing units to patients` homes
- DNF - "Do Not Forward" Initiative
and ICD-9 Diagnosis Codes - New Specificity Guidelines - New Address for ALJ Hearings Request
Effective June 30, 2005 - CMS: Any kind of physician can prescribe a scooter
HME Newswire - FAQs: Mobility Assistive Equipment (MAE)
June 2005 - CMS cuts DuoNeb reimbursement
HME News - Transitioning to the Mobility Assistive Equipment National Coverage Determination
- DMERCs Issue Mobility Coverage Transition Article, But No Additional Documentation Guidance
HomeCare Monday - RAMP wants the CMN and `something else`
HME News - Decoding the HCPCS Coding Process
- Ten Tips for NSC Compliance
- DMERCs Await Instructions from CMS on Mobility NCD
HomeCare Monday - Government Appeals Maximum Comfort Case
HomeCare Monday - Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- CMS Releases Mobility Coverage Criteria; AAHomecare Will Continue Push to End "In-the-Home" Restriction
- Long-awaited NCD draws criticism over `in-the-home` language
HME News - CMS Releases New Mobility Coverage Policy
HomeCare Monday - CMS: No sleep screening in the home
HME News - Copy of OIG "Hotline" To Report Medicare Fraud
- Justice Department sues Scooter Store
HME News - Government/Industry Affairs Update
Pride Mobility’s April 28 Update - Ten Tips for NSC Compliance
- Drug Dispensing Fee Discrepancy Catches Industry Off Guard
HomeCare Monday - SADMERC Swamped with Coding Reviews
HomeCare Monday - Changes to AOB Regulations
- As HIPAA deadline passes even the unprepared are safe – for now
- Extended Response Times for SADMERC Coding Verification Reviews
- AAHomecare Launches Oxygen Utilization Data Repository
- NSC Offers Guidance on Diabetic Shoes
HomeCare Monday - CMS delays issuing new PWC coverage criteria
HME News - SADMERC talks up 49 new PWC codes
HME News - 2005 Oxygen Fee Schedule Update
- Edwards: New Power Chair Codes Designed for Flexibility
HomeCare Monday - Home Oxygen Fees Announced
March 30, 2005 - Revenue Improvements and Other Considerations for Inhalation Therapy
By Miriam Lieber - USA Today takes compounders to task
HME News - Medicare keeps respiratory drug pricing stable
HME News - Texas study yields more PWC savings for Medicare
HME News - Power Wheelchair Coding Initiative (2004)
SADMERC Frequently Asked Questions - Providers wait: Still no word on Medicare oxygen cuts
HME News - RAMP to CMS: Clarify PWC documentation requirement
HME News - Industry comments on proposed PWC criteria
HME News 3/7/2005 - CMS Releases Interim Final Rule on Claims Appeal Reform
HomeCare Monday 3/7/2005 - Power wheelchair advocates call for changes to CMS coverage proposal
- Mobility Stakeholders Discuss Proposed National Coverage Decision at CMS
February 28, 2005 - CMS Redraws Medicare Carrier Map
HomeCare Magazine - Medical necessity of power wheelchairs update
- Electronic Claim Reminders
- Appeal Process & Tips
Supplier Number Deactivation - Examples of correct billing units for J7616 (Duoneb)
Palmetto GBA - AAHomecare Launches Gap-Filling Methodogy Study
- Modifications to Duplicate Editing for Dispensing/Supply Fee Codes for Oral Anti-Cancer, Oral Anti-Emetic, Immunosuppressive, and Inhalation Drugs
- Oxygen Uncertainty Continues
By Tim Pontius, RRT - CMS proposes new coverage criteria for wheelchairs, scooters
- CMS proposes new wheelchair coverage criteria; PWC codes
HME News - CMS Issues Draft Coverage Criteria for New Power Wheelchair Codes
- The NSC TOP TEN
"Reoccuring issues" that delay HME provider enrollment - Region C Council Q & A, November 17, 2004
- CMS Update Regarding Oxygen Payments for 2005
CMS TO BEGIN PAYING OXYGEN CLAIMS - CMS seeking public comment on home sleep testing device decision
- Respiratory Drug Fee Schedule becomes Effective; Uncertainties Remain
HomeCare Monday - Skilled Nursing Facility (SNF) Consolidated Billing Service Furnished Under an
Implementation Date: January 24, 2005 - New Inhalation Drug Therapy Codes and Fees Take Effect
- MMA - Drugs Paid by Average Selling Price Beginning January 1, 2005 for DMERC (revised)
Effective 1/1/2005 - 1) National Coverage Analysis (NCA) Tracking Sheet for Mobility Assistance Devices (CAG-00274N)
- CMS to Announce Home Oxygen Pricing in Mid-January, After Additional Data Gathering
AAHomecare - January 2005 Average Sales Price (ASP) Pricing File for Medicare Part B Drugs.
- Medigap Q&A
- CMS RELEASES PROPOSED COVERAGE CRITERIA FOR WHEELCHAIRS
Pride Mobility - GAO Recommends Actions to Curb Abuse of Power Wheelchair Benefit
AAHomecare - Medicare Region B DMERC / Region B Council Frequently Asked Questions
December 2, 2004 - Gap filling? Isn’t there a better way?
HME News - A Look at CMS` Final Rules
Dealer Provider - Medicare Seating Policy Creates Access Problems, RATC says
HomeCare Monday - Clarification of Proof of Delivery Requirements
- RATC Alerts CMS to Patient Access Problem in Wheelchair Seating Policy
RATC - Industry Reacts to Inhalation Drug Dispensing Fee
HomeCare Monday - January 2005 Quarterly Average Sales Price (ASP) Update
- Discounts on co-pays and deductibles?
- DMERC Should Be Liable for Failing to Detect Fraud, Lawsuit Says
HomeCare Monday - Homecare Win: CMS Sets $57 Monthly Dispensing Fee for Inhalation Therapy
AAHomecare - CMS ANNOUNCES REVISION TO WHEELCHAIR
- Attn: Diabetic Shoe Providers
- CMS Revises Wheelchair Cushion Fees
HomeCare Monday - Open the HCPCS Coding Process, Stakeholders Say
HomeCare Monday - Open the HCPCS Coding Process, Stakeholders Say
HomeCare Monday - FAQ: Clarification on the DMERC Advisories Relating to the New Codes for Wheelchair Cushions and Backs
- Industry attempts to rescind new Medicare cushion allowables
HME News - JOIN THE RATC AT MEDTRADE!!!
Tuesday, October 26, 2004 - New seating codes bring grief to providers
HME News, plus tips from Pehhy Walker - Summary of Power Wheelchair Coding Meeting
September 1, 2004 CMS Public Meeting - New Codes For Power Wheelchairs
Reference Document - Proposed "Face-to-face" Rule: Trap for the Unwary
Dealer Provider - Clinicians recommend a more functional Medicare policy for power wheelchairs
HME News - Medicare Panel Shows Moderate Confidence in In-Home Sleep Testing
HomeCare Monday - Appeal Process
The NSC has posted updated information - Congress Backs Functional Definition of `Nonambulatory`
HomeCare Monday - Industry doubts OIG methodology
HME News - OIG & CMS support capped rental for oxygen
HME News - CMS adopts new ASP calculation
HME News - The Issue: CMNs
From the editors of HomeCare magazine - Filing Disaster Claims
- MMA- Section 937 - Correction of Minor Errors and Omissions without Appeals for DMERC
- Mobility Stakeholders Say CMS Is Beginning to `Get It`
HomeCare Monday - Coding Changes for Power Wheelchair Suppliers: How Will They Affect You?
Dealer Provider - Extended repayment plan (ERP) checklist now available
Overpayments - Medicare Power Chair Expenditures Will Be Cut by a Third, PMC Says
HomeCare Monday - GAO: Medicare Call Centers Fall Short on Policy Info
- "Unpopular" managed-care tools re-emerge
Shorter hospital stays one result - OIG Alert About Charging Extra for Covered Services
- Can I operate a Durable Medical Equipment Company from my home?
Source: NSC - Physician’s Education – Power wheelchairs / POVs
Tips from Peggy Walker - OIG Alert About Charging Extra for Covered Services for DMERC
- OIG GIVES A NUDGE TO SLOW PAYERS
- RAMP COALITION MEETS WITH CMS ON POWER WHEELCHAIR COVERAGE ISSUES
- Medicare Should Consider PT/OT Clinician Evaluation, RAMP Says
HomeCare Monday - GAO Pans Joint Commission
HomeCare Monday - Correction of Minor Errors and Omissions Without Appeals
- NSCAC Draft Insurance Primer
Medical Equipment Suppliers "An Insurance Primer" - How Comforting Is the Maximum Comfort Case
Dealer Provider - NSC clarifies 21 Supplier Standards
HME News - CMS readies face-to-face requirement for PWCs
HME News - California Court Rules CMN Is Proof Enough for Reimbursement
HomeCare Monday - CMS hears louder call for in-home sleep diagnostics
HME News - Ostomy Supplies
Frequently Asked Questions from Your Ombudsmen - Are Your Claims Being Rejected?
- NSCAC Conference Call; Suppler Standards Draft Guidance Info
- NSC and CMS Propose Supplier Standards Clarification
HomeCare Monday - Power Wheelchair Guidance Discussed At CMS Open Door Forum
AAHomecare - Preparing for a National Supplier Clearinghouse Site Inspection: Are You Ready?
Dealer Provider - CMS Could Consider Part B Drug Service Cost Component
- Hospital-HME arrangement called a kick-back
HME News - A Copy of the National Supplier Clearinghouse "Welcome Letter"
- QUESTIONS ON THE NEW NSC REQUIREMENT
FOR INSURANCE “CERTIFICATE HOLDER” - CMS Introduces New Wheelchair Cushion Codes
HomeCare Monday - NSC Gives Providers Additional Days to Prove Compliance
HomeCare Monday - GAO Recommends Medicare Clarify Supplier Standards
HomeCare Monday - Proposed Sentencing Guideline Changes Impact Compliance Plan Operations
- Beneficiary Inducement: Avoiding the Stupid Line
Dealer Provider - Bush calls for electronic medical records
- Metzger resigns from The Scooter Store
- Diabetic Suppliers: Avoid the Death Knell
Dealer Provider - Senate to examine PWC fraud and abuse
HME NewsWire - CMS Considering Changes to Wheelchair Policy
HomeCare Monday - Mixed Reviews: CMS` first open-door session following the power wheelchair clarification retraction.
Dealer Provider - RAMP Responds to CMS` K0011 Policy Stance
HomeCare Monday - Update on 3-31 CMS Open Door on Power Mobility
From the Power Mobility Coalition (PMC) - Power Wheelchair Meeting Sends Industry Back to Square One
HomeCare Monday - NSCAC CONFERENCE CALL FINAL MEETING MINUTES
03-15-04 - OIG study cites overpayments of enteral nutrition formulas
HME News - CMS will address concerns regarding power wheelchair claims.
Dealer Provider - Congressmen Urge CMS to Rescind DMERC K0011 Clarification
HomeCare Monday - Clarifying the Clarification
Dealer Provider - Providers Support Pre-Approval Process for Power Wheelchairs
HomeCare Monday - CMS to Slow Processing of Non-Compliant Claims
HomeCare Monday - Must my company have a Respiratory Therapist on staff if it sells oxygen?: Clarification
- Could an OIG proposed rule cause you to be excluded from Medicare?
Dealer Provider - PWC denials skyrocket in Houston
HME News - ALERT! TRICENTURION CONDUCTING PRE-PAYMENT AUDITS ON POWER WHEELCHAIRS AND THERAPEUTIC SHOES
Alert from NEMED - Second Texas Power Wheelchair Scheme Sparks Congressional Hearing
Power Wheelchair Clarification Debate Heats Up - Grassley Says Surge in Medicare Spending On Motorized Wheelchairs May Signal Fraud
- Appeals and Hearings Tips
- Power Mobility - Frequently Asked Questions
Answers from Region D - Guidelines For Filing Paper Claims
Eighth in a continuing series - Coalition fights to rescind k0011 coverage criteria
HME News - What the changes in the Medicare proof of delivery and date of service rules may really mean for suppliers.
Dealer Provider - Collecting copayment and deductibles from those eligible for Medicare and Medicaid
- New rehab codes challenge providers
- Industry Stakeholders Fight DMERC Power Wheelchair Clarification
HomeCare Monday - DMERCs Update Proof of Delivery Requirements - Revision clarifies and eases the burden of HME providers’ requirements
Seventh in a continuing series - Some Common FAQs
Answers supplied by the regional DMERCs - CMS offers preview of HIPAA authorization form
- CMS ANNOUNCES PAYMENT INCREASES FOR PHYSICIANS IN 2004 IN ACCORD WITH MEDICARE REFORM LAW
Effective January 5, 2004 - Encourage reporting and prevent whistleblowing
- Paul Metzger, MD Commentary & Call To Action Re "Clarification" of Power Policy
Former DMERC Medical Director Encourages Providers to Submit Comments - OIG seeking recommendations on safe harbors, fraud alerts
- Are the DMERCs Changing Power Chair Policy?
Dealer Provider - POWER WHEELCHAIR UPDATE
AAHomecare - OIG boasts record year for audits, investigations
- Power Wheelchairs and POVs – Policy Clarification and Medical Review Strategy
Fifth in a series - OIG: We saved taxpayers a bundle
- Where’s Your Guide?
It’s Time To Dust Off (Or Find) Your VGM Medicare Supplier Standards Guide! - CR 2613: CMS dreams up billing nightmare
HME Newswire - CMS ignores industry’s plea to revamp PWC codes
HME News - OIG Thinks Medicare Is Overpaying
Notice of Proposed Rule Making - May Affect Supplier Operations - Standard 12 - May I contract delivery and instruction services out to someone else?
Fourth in a series - OIG Work Plan targets HMEs
HME News - Debunking Medicare Myths
Commentary from Michael W. Hamilton, GAMES Executive Director - The Power Mobility Industry & Fraud
Commentary from HomeCare Advocate - Must my company have a Respiratory Therapist on staff if it sells oxygen?
Third in a series - HMESA/Standardization Information
Dealer Provider - “Home Based” HME Information and Check List
Second in a series - OIG Work Plan for 2004 – HME Providers
OIG Encourages Reporting Fraud - VGM provides helpful tips to reduce incidence of supplier number deactivations
First in the series: Change of Information Guide - Supplier Number Moratorium Update
Source: ADMEA - NSC Moratorium Examples & Information
AAHomecare - Letter To Tom Scully - Re Moratorium on New Supplier Numbers
AAHomecare - Houston Power Wheelchair Indictment Unsealed
- Supplier Number Re-enrollment Tips from Peggy Walker
- OIG trying to clear confusion surrounding excessive claims
- Feds Crack Down on Power Wheelchair Fraud
HomeCare Monday - ARE YOU HIPAA COMPLIANT?
Good October 16 Compliance Link Here - IMPORTANT MESSAGE FROM THE NSCAC
Re Blanket Moratorium on DMERC Numbers - Medicare 10 Point Plan on Power Mobility - Association Responses
MESA Press Release - AAHomecare Declares Zero Tolerance for Medicare Fraud & Abuse
- Power Mobility Coalition Commends Fraud Crackdown
HomeCare Monday - Feds crack down on Houston wheelchair scam
- Conferees limit extrapolation
HME News - Good Q&A From June 2003 Region C Meeting
- AdminaStar Federal List Serve - July 21
ARE YOU HIPAA COMPLIANT? - JCAHO Posts Revised Standards
- CMS: DME Only Open Door Session June 26 @ 2 PM
Coordinated by AAHomecare - HME Providers & Accreditation: Comment
Source: Dealer Provider - JCAHO releases 2004 home care draft standards
- Tip: Challenge Medicare overpayment determinations
- CONTRACTUAL JOINT VENTURES - WHAT HME SUPPLIERS NEED TO KNOW
Elizabeth E. Hogue, Esq.
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