MACs may now conduct post-payment medical reviews of items and services with dates of service after March 2020.
- By David Kopf
- Jun 03, 2021
Several months ago CMS threatened it would resume its claims audits. Now that is happening and audit expert Wayne van Halem provides the details on what’s happening and what providers need to know.
- By David Kopf
- Apr 07, 2021
OMHA reports to AAHomecare that within a year, the number of pending DMEPOS appeals fell by 51 percent.
- By David Kopf
- Nov 19, 2020
Virtual edition of Provider Compliance Focus Group shared information on TPE audits and recommendations it made to the DME MACs.
- By David Kopf
- Oct 22, 2020
Observation Deck
CMS's announcement that audits would resume Aug. 3 was a shock. Then CMS said it would phase audits back in. What are the details?
- By Wayne van Halem
- Oct 01, 2020
The review from CGS is the result of errors and high payouts for four codes, and should impact claims filed prior to the COVID-19 PHE.
- By David Kopf
- Sep 17, 2020
Audit expert Wayne van Halem joins the HME Business podcast to discuss how CMS will phase its audits back in, and how providers should prepare.
- By David Kopf
- Sep 17, 2020
Observation Deck
The news that CMS planned to resume audits by Aug. 3 took many by surprise. Then CMS said it would resume audits in a phased approach. What are the details and what can providers expect?
- By Wayne van Halem
- Aug 13, 2020
After AAHomecare shared industry concerns over audit resumption, CMS provided a more nuanced and detailed description of how the audit programs will recommence.
- By David Kopf
- Jul 23, 2020
Postponed since March 30, TRP, SMRC and RAC audits will restart next month, as will prior authorization for PMDs and support surfaces.
- By David Kopf
- Jul 16, 2020
Business Solutions
As epidemiologists and public health officials first started warning about COVID-19, some HME providers were already making plans. How has the industry responded to the public health emergency? How have these changes impacted their businesses and patients? How has public policy adjusted? How might all these changes impact the future of the HME?
- By David Kopf
- Jun 01, 2020
In addition to the $30 billion COVID-19 relief fund, HME providers have seen a cascade of Federal and state regulatory changes, as well as new private payer funding guidelines. AAHomecare regulatory and payer relations experts Kim Brummett and Laura Williard take a deep dive into all of them.
- By David Kopf
- Apr 21, 2020
A shift in scams run by the types of bad actors involved in 2019’s $1.2 billion orthopedic brace fraud ring has new lessons HME providers should take a moment to understand.
- By Jeffrey S. Baird
- Apr 16, 2020
Top-line audit concern includes HHS OIG adding PAP supplies to Its workplan. Wayne van Halem will discuss several new, worrying audit developments and how to prepare for them in Dec. 11 webinar.
- By David Kopf
- Nov 26, 2019
Podcast
Sleep equipment providers risk facing costly six-year lookback audits in this new addition to OIG's workplan. How should they prepare?
- By David Kopf
- Oct 17, 2019
The medical device manufacturer says the certification will allow for more growth in the market and improved efficiency.
- By Haley Samsel
- Oct 14, 2019
Business Solutions
CMS's six-year lookback audits represent a daunting challenge for HME providers, but there are steps they can take to deal with them.
- By Holly J. Wagner
- Oct 01, 2019
Performant will only review HCPCS code A4253 and claims paid date must be within three years before the Additional Documentation Request.
- By David Kopf
- Jun 20, 2019
Provider Strategy
Understanding another 'new normal' for HMEs from HHS OIG.
- By Wayne van Halem
- Jun 01, 2019
California respiratory and sleep provider notches its fourth 12-month break from TPE audits.
- By David Kopf
- May 30, 2019