Ambulance trips for dialysis treatment rose 269 percent for Medicare recipients between 2002 and 2011, while the number of covered trips overall rose 69 percent, the Office of Inspector General found in a new report. Although dialysis clinics are approved as a...
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Reimbursement
NCTracks Continues to Devastate Medical Businesses
During the final week of August, Jordan Karimi was spending his days cleaning up the office, making final phone calls and saying goodbye to co-workers. Karimi, 28, had worked for his parents for the past five years. Their company, Right at Home, had provided home...
Repair Crisis Deepens Across Pennsylvania and the Nation
Ann Eubank from UsersFirst has advised PAMS that CMS has asked United Spinal Association to take the lead on gathering consumer data on a rapidly degenerating repair access crisis in the DME sector that is leaving consumers frustrated and without properly functioning...
Congressman Rothfus vows to modify Medicare bidding plan
U.S. Rep. Keith Rothfus told local business owners on Wednesday that he'll lobby to change Medicare's rules governing bidding by medical equipment suppliers. Rothfus, R-Sewickley, said he is one of 150 co-sponsors of a House bill that would change a controversial...
GAO Releases Report on CMS Auditors
The Government Accountability Office (GAO) released a report titled "Increasing Consistency of Contractor Requirements May Improve Administrative Efficiency." GAO undertook the study at Congress' request because questions have been raised recently about the efficiency...
Competitive Bidding Prices coming to Medicaid?
A Recent OIG report suggests Texas Medicaid DMEPOS costs may be exceeding medicare costs in Competitive Bidding Areas. WHY OIG DID THIS STUDY States establish their Medicaid payment amounts for all services—including items in the category of durable medical equipment,...
PA DPW Issues Remittance Advice Alert: Voiding of Certain Durable Medical Equipment Claims
The Pennsylvania Department of Public Welfare through the Comptroller’s Office has completed a special review of durable medical equipment (DME) rentals that paid in error without prior authorization after three months rental as required by Medical Assistance (MA)...
HME News: CMS throws safety net to oxygen patients
It appears CMS has finally realized that you can’t get blood from a stone—or oxygen equipment and services from an HME provider that has gone out of business. CMS announced on Aug. 22 that, effective immediately, a new provider can replace oxygen equipment and restart...
CMS finalizes two-midnight rule for hospital inpatient admissions
The Centers for Medicare & Medicaid Services has issued a final rule on hospital inpatient status, which is likely to boost the number of seniors receiving Medicare coverage for skilled nursing services. Medicare beneficiaries must have inpatient status at a...
Flaws in NCTracks Highlighted by Audit Before Implementation
For weeks, FOX8 has reported stories about NC Tracks and local providers’ frustrations with the state’s new online Medicaid billing system. Doctors, therapists and billing experts we’ve talked to say they are not being properly reimbursed for Medicaid patients’ bills....
Bidding and wheelchairs: ‘The system is not working’
Industry warnings of access problems due to Round 2 of competitive bidding are becoming a day-to-day reality for power wheelchair users. Providers report users are facing extended wait times for equipment and little or no options for repairs due to contract suppliers...
CMS Proposes Capped Rental Rule for DME
The Centers for Medicare and Medicaid funding have proposed a rule to rent “routinely purchased” DME items falling under the three-year minimum lifetime requirement and that have allowables of more than $150. Under the proposed rule, Medicare would only purchase an...