David Kopf

Editor's Note

Making the Right Thing Happen

The window for public comments on CMS’s proposed power seat elevation NCD ends March 17. There are several resources you can use to help support the effort.

DME MACs Finalize Expanded CGM Coverage

An LCD update and policy article make the expanded coverage for continuous glucose monitors effective before the end of the Covid-19 PHE.


Solving HME’s Tricky Staffing Challenges

In a job market with high turnover, how can providers attract and retain the best talent for the job—and maybe add some new strengths in the process?

AAHomecare Working with Policymakers on e-Prescription

The association is measuring lawmakers’ and regulators’ interest in e-prescription and plans to discuss the topic on an upcoming call with CMS.

CMS Proposes Power Seat Elevation Coverage

Proposed NCD would expand coverage for power seat elevation on certain power wheelchairs to Medicare beneficiaries for the first time.

Numotion Agrees to a $7 Million Medicaid Settlement

The settlement involved claims that hinged on a set of Medicaid billing regulations that the company believed it had interpreted correctly.

False Healthcare Claims Settlements Hit $1.7 Billion in 2022

The DOJ reports that 2022’s False Claims Acts settlements included claims for DME, drugs, home health, managed care, hospitals and physicians.

NHIA Releases Recommendations to Improve Home Infusion Access

The eight recommendations are designed to be incorporated into contracts between health plans and home and alternate site infusion providers.

Two Doctors Convicted in $31 Million DME Scheme

Those involved acquired patient referrals and signed doctors’ orders by paying kickbacks to marketers who used overseas call centers to solicit Medicare beneficiaries for unneeded DME.

Covid-19 PHE Ending on May 11

Biden Administration announces an end to the public health emergency that goes beyond its current April 11 cut-off.

Virginia Legislation Would Boost Medicaid Reimbursements

A pair of legislative efforts would raise Medicaid reimbursements in the state and authorize Medicaid coverage of CRT wheelchairs for patients living in nursing facilities.

ALJ Overturns Disputed Claims Against VieMed

An ALJ has overturned all disputed claims from a 2021 HHS OIG report, and Medicare Administrative Contractors have returned 100 percent of the recouped funds to the provider.

DoD Awards TRICARE Managed Care Contracts for 2024

A total of $136 Billion in TRICARE Managed Care Support Contracts will be split between two major health contractors.

Industry Roundtable

A Look Ahead

Experts discuss key trends, challenges and opportunities that will impact HME providers and how those businesses can respond to them.

AAHomecare Sets its 2023 Policy Objectives

The association’s Federal policy agenda includes further extending the 75/25 blended rates, advancing the 90/10 blended rates in CBAs, and more.


Medicare Advantage Audits’ Impact on HME Providers

CMS has intensified its scrutiny of Medicare Advantage health plans, and in turn those plans are auditing HME businesses. How should providers respond?

HHS Extends Covid-19 PHE Another 90 Days

The public health emergency’s reimbursement and regulatory policies impacting HME providers will continue until April 12.

N.Y. DME Owner Arrested for $17 Million Conspiracy

DOJ apprehends a New York woman for allegedly offering and paying illegal health care kickbacks for false orthotic braces and continuous glucose monitors claims, as well as money laundering.

House Passes $1.7 Trillion Spending Package

The year-end bill to fund the government includes key HME reimbursement provisions. The legislation now goes to the Pres. Biden to be signed into law.

Draft Spending Bill Includes DME Provisions

As Congress now moves vote on the year-end budget package, the legislation includes language concerning key HME reimbursement objectives.

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