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?

Recent CMS audits of Medicare Advantage plans uncovered roughly $12 million in net overpayments. Moreover, CMS said it was going to extrapolate the payment error rates across all Medicare Advantage plans to recoup an estimated $650 million. As a result, Medicare Advantage plans are now auditing the companies with whom they work—including HME providers.

In the latest episode of the HME podcast, audit expert Wayne van Halem, president and founder of the audit consulting firm The van Halem Group, discusses what this means for the industry and how providers should respond.

Listen on your favorite podcast app, or here:

The HMEB Podcast examines essential news, trends, and developments and interviews industry experts to find out how HME provider owners and operators can run efficient, profitable, and growing businesses with an eye on patient care.

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About the Author

David Kopf is the Publisher HME Business, DME Pharmacy and Mobility Management magazines. He was Executive Editor of HME Business and DME Pharmacy from 2008 to 2023. Follow him on LinkedIn at linkedin.com/in/dkopf/ and on Twitter at @postacutenews.

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