CMS has implemented a 120-day grace period for obtaining documentation for CPAP devices and supplies in areas included in Round 2 of competitive bidding, officials announced during an Open Door Forum July 9. The move is in response to contract suppliers notifying CMS...
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Reimbursement
The Fight Against Competitive Bidding
Problems with Round 2? Call Congress on July 18 Just nine days into Round 2, AAHomecare is receiving reports of delays, equipment shortages, and contractors refusing services in bid areas around the country. Yet, CMS is reporting just a few dozen complaints. Don’t let...
NCAMES: NCTracks Update July 9th 2013
The great team at NCAMES has been keeping in close contact with CSC. Earlier today the following email correspondance was received by NCAMES from CSC regarding NCTracks system issues and claims processing. NCTracks Update Many of you may have heard the good news-that...
CSC Provides NCTracks Claims Processing Update
NCTracks Claim Processing Update Provided directly by CSC. Today marks the beginning of the second week of operations for NCTracks, the new claims processing system for the North Carolina Department of Health and Human Services (DHHS). We have processed over two...
Aetna Revises DME Policies for TENS
Aetna Health Plan has revised their TENS policy effective 6/25/2013 to state that TENS is considered experimental and investigational for chronic low back pain. Change in Stance Aetna now considers transcutaneous electrical nerve stimulators (TENS) medically necessary...
CMS quiet on Skilled Care Reimbursement Changes Fueled by Lawsuit
In recent years, many skilled care operators have nervously watched the Centers for Medicare & Medicaid Services reduce and sometimes eliminate payments for physical, occupational and speech therapy services. But thanks to a recent class-action lawsuit settlement,...
OIG to CMS: Rein in CPAP supplies
The Office of Inspector General (OIG) recommends that CMS review and revise the replacement schedule for CPAP supplies in a report published today (June 26). The OIG studied the replacement schedules of 50 fee-for-service state Medicaid programs and found that 39% had...
Senate Finance Committe Warns of Audits Hurting DME Providers with Red Tape
In a Senate Finance Committee hearing this past Tuesday, Chairman Max Baucus (D-Mont.) called on Congress and the administration to strengthen a key Medicare program that saves taxpayers millions of dollars each year by rooting out improper payments to health care...
Patient View: New Mediare Diabetic Testing Supplies Program
July 1st Medicare patients with diabetes will have to change how they get their diabetic testing supplies. That is when Medicare Part B will implement a national mail-order program. In South Dakota, 68-year-old Herb Grogan has a difficult time getting around. The...
Lawmakers call on OIG to investigate competitive bidding
In a June 21 letter to the Office of the Inspector General (OIG), Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, call on the agency to investigate the possibility that CMS deliberately overlooked its own rules when awarding contracts for competitive bidding,...
Oregon Revives Bill to Crack Down on Regence BCBS Payments to ASCs
Oregon's House of Representatives has revived a measure that will prevent abusive payment practices to ASCs by Regence BlueCross BlueShield, according to The Lund Report. The measure, called the rider amendment, was tacked onto Senate Bill 724, which passed a House...
Reality Check: Competitive Bidding Program Myths Versus Facts
The Medicare DMEPOS Competitive Bidding Program Myths Versus Facts Reality Check Recently CMS released a document titled "The Medicare DMEPOS Competitive Bidding Programs: Myths vs. Facts". This document outlined what CMS described as "Myths" of the...