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Author: Kelsey Kansler

Regulatory Insight

Updates from the DMEMAC Jurisdiction C: CMS FHIR, CGS Connect Enhancements, and More

The most recent JC Council meeting covered several key initiatives from CMS and CGS that could impact providers’ workflow, claim submissions, and communication processes. Here’s a breakdown of what you …

Regulations

NC Medicaid Rate Reductions Are Now in Effect

As of October 1, 2025, North Carolina Medicaid has implemented provider rate reductions that are already affecting reimbursements across multiple care categories, including DME AND HME services. The North Carolina …

Industry

Final CMS NCD Expands Coverage for NIPPV in the Home—Here’s What to Do Now

The Centers for Medicare & Medicaid Services (CMS) has finalized its national coverage determination (NCD) for noninvasive positive pressure ventilation (NIPPV) in patients with chronic obstructive pulmonary disease (COPD) who …

Regulatory Insight

CMS Proposed Rule Could Slash Reimbursement and Limit Contracts—Here’s What to Know

A newly released CMS proposed rule could significantly reduce DMEPOS reimbursement rates and limit the number of Medicare contracts available—changes that would be especially harmful to small providers.  The DME …

Regulatory Insight

Medicare Issues Final Decision on RAD and HMV Coverage for COPD

CMS has released a final National Coverage Determination (NCD) that expands and clarifies coverage for certain respiratory devices used in the treatment of chronic respiratory failure due to chronic obstructive …

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