HME News: Providers debate prior auth proposal
A majority of HME providers welcome the idea of prior authorizations for certain DME, but they say Medicare’s proposed timeline for returning decisions is unreasonable. Sixty-nine percent of the 160 …
Breaking News: Advance Copy of New CMS Proposed Rule
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 …
CMS Proposes Medicare Prior Authorization Process For DMEPOS Subject To “Unnecessary Utilization”
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 …
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 …
Face-to-Face Requirement Language Added to LCDs and Policy Articles
On March 6, the Medicare audit contractors announced the addition of face-to-face language to the following local coverage determinations (LCDs) and policy articles: • Automatic External Defibrillators • Hospital Beds …
New HCPCS Code (K0900) for Custom DME
According to Joint DME MAC A, a new HCPCS code, K0900, has been created for use with custom fabricated durable medical equipment other than wheelchairs. 42 CFR §414.224(a) describes the …
New RAC Audits Posted
New RAC Audits Posted Region A Performant Recovery, the recovery audit contractor (RAC), posted a complex review for automatic external defibrillators on December 26 that will specifically look at claims …
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 …