Audits


The van Halem Group Adds Senior Consultant

Kelly Grahovac joins audit, compliance consulting firm after a decade with Medicare contractor.

Audits

The 2013 HME Handbook: Audits

Getting Your Ducks in a Row

Senate Finance Hints at Program Integrity Changes for CMS

After soliciting stakeholders’ input a new report from committee summarizes their concerns.

The van Halem Group Hires Additional Medicare Clinician

Jane Naig, RN, CFE, AHFI, joins audit consulting firm as senior clinical consultant.

HHS Could Boost Fraud Reward to Nearly $10 Million

Secretary Sebelius launches proposed rule to boost reward payout for reporting acts of Medicare fraud.

Industry Newsmaker

Bridging Worlds

Wayne van Halem applies 11 years’ experience at Medicare to give providers audit assistance. Getting there has been an interesting journey.

Rock-Solid Documentation

Business Solutions

Steps to Rock-Solid Documentation

As providers continue to find themselves swimming in a sea of post- and pre-payment Medicare audits, they know flawless documentation is their best life line. What are the key ways they can implement strong documentation?

2011 RAC Audits Save $488 million of $797 Million Collected

After underpayments and costs, only $488 million goes to trust fund; DME overpayments account for less than 5% of overpayments.

Observation Deck

Medicare's Most Stringent Audits

In many cases, especially for power mobility devices (PMDs), a provider may not know whether a file meets all of the requirements until an audit occurs, due in part to the subjectivity of medical necessity documentation review.

GAO, AAHomecare Discuss Audit Issues

Accountability office meets with association to ask various questions regarding post-payment audit cocnerns.



Problem Solvers

Preparing for Potential Audits

Increased funding and more Medicare claims processors could mean more audits for 2013. How should HMEs prepare?

OPGA Partners with The van Halem Group

Audit consulting firm will help OGPA members in audits, compliance, appeals.

MEA, van Halem Group Partner for Audit Solution

Providers will be able to electronic respond to auditors’ documentation requests.

CMS Puts Hold on Audits for HMEs Hit by Hurricane

Agency to tell contractors to suspend audits for providers affected by Sandy.

Round Two: Bracing for 2013

Industry Roundtable

Round Two: Bracing for 2013

The coming year promises a rough ride for the industry. Providers face many issues: competitive bidding Round Two; the fight to replace it with the MPP; the continued assault of pre- and post-payment audits; the pending face-to-face rule; and pior authorization for power mobility to name just a few. HMEB’s editorial advisory board discuss these issues and more and share their insights on how providers should approach 2013.

Taking the Bite Out of Oxygen Documentation

Audits

Taking the Bite Out of Oxygen Documentation

Although the denial rate may be improving, oxygen audits continue to challenge and frustrate providers. How can providers become oxygen audit ready?

White Paper Informs Senate of Major Flaws in CMS Audits

VGM, providers, law firm submit document that informs Finance Committee of key problems with audit structure and their solutions.

Lawmakers Push GAO to Examine CMS Audits

Leading Sens. and Reps. call for an examination into ‘duplicative efforts’ of Medicare audit contractors.

Congress Questions CMS on Audits

House subcommittee chair blasts CMS for ‘incompetence’ in audit oversight.

Editor’s Note

Enough Is Enough

HME Business Podcast

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