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.
Yesterday afternoon, AAHomecare received an advance copy of a proposed rule for prior authorization of DMEPOS items in Medicare Part B. In this proposed the rule, CMS is soliciting public comments on establishing criteria for a master list of durable medical...
CMS has just released a proposed rule that would require Medicare prior authorization (PA) for certain Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items that the agency characterizes as "frequently subject to unnecessary...
CMS wants to focus on improper payment prevention, but will providers see fewer burdens? With Medicare’s “two midnight rule” set to take effect later this year and audit appeals facing lengthy backlogs, the Recovery Audit Contractor program may be headed in some new...
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...
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 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...
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...
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. 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...
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...
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...
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...
