Funding


Inaccurate Claim Denials Overturned

VGM effort to collect inappropriate denials for OMHA meeting pays off for providers.

Just How Complex, Costly Are Medicare Orders?

AAHomecare infographic illustrates the high costs associated with Medicare DME transactions.

Breaking Through Audits

Business Solutions

Breaking Through Audits

CMS's audit onslaught has been a trial and tribulation for the HME industry, but matters took a turn for the terrifying when the agency announced that it would delay assigning Administrative Law Judges to audit appeals by two years. Now the industry has redoubled its efforts to bring an out-of-control situation back under control.

Documentation: Dealing With Audits

While providers fight audits on the legislative front, they need to have a plan for dealing with them.

CEDI Calling on ICD-10 Volunteers

Participants for each DME MAC will help prepare for Oct. 1 transition.

Observation Deck

Repair Guidelines Need Repairs

Providers’ profit margins determine how extensively they can provide comprehensive services, and in no division is this dynamic more important than in the DME repair arena. That's why the scenario of DMEMAC Medical Directors setting allowed labor limits on repair services must change.

AAHomecare Outlines Audit Reform Objectives

Association advises Senate Finance Committee, gearing up to launch legislation, other initiatives.

HHS, DOJ Recover $4.3B in Fraud

Latest report details various instances of Medicare fraud, but doesn’t focus on DME as the central cause.



Industry Confusion over Face-to-Face Remains

AAHomecare letters seek clarification from CMS’s General Counsel on various points.

Industry Asks for Capped Rental Delay

Round One Re-compete and Round Two reimbursement add layer of complexity, confusion to implementation.

Medicaid Bidding Proposal Re-Surfaces

AAHomecare fights suggested legislation that would see competitive bidding rates applied to Medicaid in order to cover ‘doc fix’ costs.

Video: HMEs Comment on OMHA Meeting

VGM members share their thoughts on Appellant Forum proceedings, two-year ALJ delay.

Observation Deck

Flirting with Disaster

OMHA’s decision to delay assigning ALJs to audit appeals for up to more than 24 months does far more damage than holding recouped reimbursement in limbo. Even a cursory investigation of the latest developments make it patently clear that these delays may put more Medicare providers out of business than any other issue facing healthcare companies today.

Industry to OMHA: Audit Process Is Broken

AAHomecare’s Ryan tells OMHA’s Griswold that ALJ delay has put providers in ‘crisis mode’ and a fix is needed fast.

Medicare PAP Use Outpacing Other DME

Number of beneficiaries using sleep devices up 13%, allowed charges up 23% from 2012 to 2013.

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