Survey: Mail-order program reduces access

Medicare’s national mail-order program for diabetes testing supplies has sharply reduced beneficiary access, says a new survey from the America Association of Diabetes Educators. The “secret shopper” survey found that: The number of manufacturers making diabetes testing supplies available under the mail-order program has fallen 50% since the program started; The number of diabetes testing Read more about Survey: Mail-order program reduces access[…]

HME News: CMS eases requirements for changing providers

WASHINGTON – CMS has instructed the DME MACs to accept timely orders and medical documentation whether they come from a beneficiary’s treating physician or a transferring HME provider. The change is a big deal for providers in competitive bidding areas, where transfers of beneficiaries from non-contract to contract providers are common. “Industry (has) suggested that Read more about HME News: CMS eases requirements for changing providers[…]

HME News: Stakeholders question authority to bundle

WASHINGTON – CMS does not have the authority to implement bundled bidding programs for CPAP or other HME, because it would jeopardize patient access to specific equipment, say industry stakeholders. Bundling a CPAP device, consumable items, maintenance and service into a single monthly payment will cause disruption for suppliers and will provide an incentive to Read more about HME News: Stakeholders question authority to bundle[…]

Using the New Request for Hearing Form for Medicare Appeals

The advent of revised regulations for administrative law judge (ALJ) hearings of Medicare appeals includes a new request for ALJ hearing or review of dismissal form. Because the new form — governed by 42 C.F.R. § 405.1014 — provides a logical flow of information for you and the public servants handling your appeal, you should Read more about Using the New Request for Hearing Form for Medicare Appeals[…]

Register Now: CMS Stakeholder Input Call for DMEPOS Non-CBA

CMS announced a call to discuss the non-CB impact of CURES with stakeholders on Thursday, 3/23 at 2p Eastern.  According to the CMN announcement, CURES mandates Stakeholder input on the methodology for using information from the DMEPOS Competitve bidding program for adjusting Medicare fee schedule amounts paid in non-CB areas. Learn about new legislation and provide Read more about Register Now: CMS Stakeholder Input Call for DMEPOS Non-CBA[…]

HHS says Medicare Appeals Backlog Will Be Worse by 2021

After being directed by a court order to clear out the Medicare backlog of home health care claims appeals, the Department of Health and Human Services (HHS) is predicting the backlog will only grow by the time the backlog is meant to be eliminated. In December last year, HHS was ordered to clear its backlog of pending Read more about HHS says Medicare Appeals Backlog Will Be Worse by 2021[…]

Jimmo plaintiffs complain in court that CMS still using ‘improvement standard,’ despite landmark settlement

Plaintiffs’ counsel in Jimmo v. Sebelius was back in court Tuesday to file a motion that would force the Centers for Medicare & Medicaid Services to adhere to the settlement of the landmark lawsuit. The case involved Medicare beneficiary Glenda Jimmo, who was denied coverage for treatment of her chronic, diabetes-related conditions because she was Read more about Jimmo plaintiffs complain in court that CMS still using ‘improvement standard,’ despite landmark settlement[…]

OMHA Announces ALJ Appeal Status Website

This week, the Office of Medicare Hearings and Appeals (OMHA) announced the launch of a new website which will allow providers to check the status of their ALJ appeals. The website, entitled the ALJ Appeal Status Information System (AASIS), intends to provide public access to appeal status information. The website is accessed through the OMHA Read more about OMHA Announces ALJ Appeal Status Website[…]