Medicare officials want to make it harder for their recovery-audit companies to collect fees for auditing hospital and doctor bills. Earlier this week, the Government Accountability Office gave the CMS the go-ahead to make the change despite protests from the...


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Stay informed with Medbill’s blog, where we share expert guidance, practical tips, and industry updates to help DME providers navigate the industry’s complexities.
Reimbursement
CMS Website Finally Recognizes ICD-10 Delay
Weeks after the President signed the temporary Sustainable Growth Rate (SGR) "doc fix" bill that included a one-year extension to ICD-10 implementation, the Centers for Medicare and Medicaid Services (CMS) has just now updated its website to acknowledge the delay. In...
Industry ‘ready’ for prior auths
Industry stakeholders support CMS’s plans to expand the PMD demo—with a few tweaks. “I’m all for it,” said Peggy Walker, billing specialist at VGM. “I’m ready for more prior auths.” In an April 4 emergency Federal Register notice, CMS detailed plans to expand the...
OIG Issues Report on Limited Compliance with Medicare’s Face-to-Face Requirement for Home Health Services
On April 9, 2014, the US Department of Health and Human Services Office of the Inspector General’s (OIG) Office of Evaluation and Inspections (OEI) issued a report (OEI-01-12-00390) entitled “Limited Compliance With Medicare’s Home Health Face to Face Documentation...
Medicare Advantage plan sponsors weigh reimbursement increase
The region’s two biggest Medicare Advantage plan sponsors say they are reviewing government reimbursement rates for next year before making any decision about member benefits. The Centers for Medicare and Medicaid Services recently issued the fiscal 2015 rates for...
U.S. insurers still expect cuts in 2015 Medicare payments
U.S. health insurers said on Tuesday they still expected cuts in government reimbursements for privately managed Medicare health plans for the elderly next year even after the White House administration rolled back the steepest reductions. The government agency that...
Sweeping Changes to Medicare Payment for Clinical Laboratory Services
On March 31, 2014, the Senate gave final approval to the Protecting Access to Medicare Act of 2014 (the Act), which includes significant reforms to the way Medicare pays for clinical diagnostic laboratory services. The House approved the Act on March 27, and the...
HME News: Capped-rental rule takes effect
Although providers hoped to hear “April Fools,” the rule transitioning certain complex rehab items to capped-rental status went into effect Tuesday as planned. “This change in regulation is so ridiculous, and the basis behind it is so ridiculous, that my Pollyanna...
AAHomecare PR Spurs CMS to Action
Back in January, AAHomecare issued a press release about Leonce Pierre-Lewis, a patient in New Jersey who was having trouble getting a replacement wheelchair from Medicare. This week, the Association learned that CMS has taken notice and is working with the patient to...
CMS May be Sued over Face-to-Face Requirements
The National Association for Homecare (NAHC) is laying the groundwork for a possible lawsuit against CMS’ implementation of the Affordable Care Act’s (ACA) home health face-to-face requirements. NAHC says that providers are frustrated with face-to-face denials and...
Call to action! Join the fight to add DME to the SGR fixes.
Please click on this link, www.vgmdclink.com, to send a message to your members of Congress. Complete both Actions 1 and 2 to send one to your senators and another to your representative. PAMS and VGM are asking the representatives to act on these three items: 1. Add...
Medicare to cover hospice and curative care simultaneously in new demonstration program
Medicare will reimburse both hospices furnishing palliative care and providers offering curative services under a new demonstration program, the Centers for Medicare & Medicaid Services recently announced. Currently, a beneficiary must end curative treatments in...









