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
AAHomecare facilitates in-person meetings between lawmakers and industry advocates in Washington, D.C.; coordinates virtual fly-in for providers to remotely assist lobbying push.
- By David Kopf
- May 23, 2019
Latest installment in HMEB’s quickly growing podcast survey examines breast cancer legislation and six-year lookback audits.
- By David Kopf
- Mar 14, 2019
Business Solutions
Are you setting the right strategy for 2019? This marks our 11th annual survey of the 10 key trends that will impact the home medical equipment industry the most during the New Year. In this year's list, larger healthcare and retail trends could impact HME more than anticipated. As a result, this installment of the Big 10 list is a must-read.
- By David Kopf
- Jan 01, 2019
Editor's Note
DMEPOS represents an outsized share of audit appeals at ALJ. Providers must take action first.
- By David Kopf
- Dec 01, 2018
Observation Deck
How to approach the CGS/Noridian letter and the '60-Day Rule.'
- By Jeffrey S. Baird, Wayne van Halem
- Dec 01, 2018