Audits


Industry Forecast

HME Business 2016 Annual Industry Forecast

2016 Big Ten

Each year HME Business profiles 10 upcoming trends that will help define the industry over the next 12 months. To be certain, competitive bidding will be one of those factors. Others challenges include audits and protecting complex rehab. But 2016 also offers opportunities, as well, such as retail sales and revenue diversification.

Audit Appeal

Business Solutions

Winning the Audit Appeal Game

Medicare claims audits do not stop at claims being recouped. If anything the process just begins. As providers have realized early on in the process, many audits can and should be appealed. We talked to various experts to outline the appeals process and understand how providers can improve their chances through the various steps.

Audit Key Goes Live in 2016

Providers encouraged to register for program that will help accumulate data that industry will use to reform CMS’s audit program.

Editor's Note

Built to Fail

Quality was not 'job one' when CMS designed its audit program — which need serious and immediate retooling.

Some States See Post-Pay Audits on Parenteral Nutrition, Ventilators

With high denial rates in Jurisdiction A, it is likely the audits will expand.

Smart Strategy

Business Solutions

Setting a Smart Strategy

Providers face many challenges, but it’s time to turn the tables. Various experts assess the market and help determine how providers can set a smart course for success.

Provider Strategy

esMD: Your Secret Weapon

CMS offers a key methodology to help providers follow-up on documentation requests for audits, PMD prior authorization and appeals.

Average Audit Appeal Processing Time Surges to 714 Days

AAHomcare analysis shows a whopping 2122% increase in DMEPOS-related audit appeals over past 8 years.

Mont. Providers Urged to Attend SBA Hearings

July 21, 23 forums will give local HME providers an opportunity to publicly voice their concerns regarding audits, competitive bidding expansion.

CMS Pays $1.3 Billion to Settle Hospital Claims

CMS settles with 1,900 on audited claims stuck in OMHA. AAHomecare asks, ‘Is there anything in sight for DMEPOS?’



Senate Finance Committee Passes Audit Reform

Audit & Appeal Fairness, Integrity, and Reforms in Medicare Act aims to add transparency, oversight to audits and appeals process.

Observation Deck

RAC Audits: Changes Are Coming

The remarkable increase in RAC audits has put a huge financial burden on providers to simply respond, and major changes are in the works, including improvements. What do providers need to know about what's happening with the program, and how should the prepare?

2015 HME Handbook

How to Properly Prepare Your Organization for ICD-10

The Department of Health and Human Services issued a rule setting Oct. 1 as the ICD-10 compliance date for healthcare providers, health plans, and healthcare clearinghouses. What should HME providers do to ensure they comply?

Rep. Blackburn Introduces Prior Authorization Bill

Tenn. lawmaker’s legislation would require CMS program to establish a program for higher cost DME similar to the power mobility demonstration project.

Washington Legislative Conference Just Around the Corner

Next week’s event gives providers an opportunity to lobby lawmakers and their staffs on behalf of various industry legislative initiatives.

Senate Hearing Highlights Audit Debacle

Senate Finance Committee explores problem of audit backlog, reviews possible methods to reduce problem.

AAHomecare Gears up for Washington Conference

Slated for May 20-21, the annual meeting and legislative push will cover key industry issues.

GAO Dismisses Protest over RAC Contract

CMS will likely move forward with assigning contract to Connolly LLC; reasons for dismissals are unclear.

NCAMES to Visit Sen. Burr's Staff


Meeting will focus on the impact nationwide expansion of competitive bidding in 2016 would have on providers, patients.

Industry Scores an Audit Win

Association worked with CMS to change the automatic RAC audits on DME claims related to Part A SNF, hospital stays.

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