October Archives

Join VGM Government Relations for a webinar this Monday, November 2 at 2 p.m. CT, which will include information about the latest announcement regarding Competitive Bidding Round 2021. 

Round 2021 Competitive Bidding is canceled EXCEPT for knee and back braces. Register today and get the information you need to know!

Click here to register.

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The following is an excerpt from the offical “CMS Round 2021 DMEPOS Competitive Bidding Program Single Payment Amounts and Contract Offers” announcment. 

The Centers for Medicare & Medicaid Services (CMS) competed 16 product categories in 130 competitive bid areas (CBAs) in Round 2021 of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP), although the product category for non-invasive ventilators was removed...

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The Coronavirus Aid, Relief, and Economic Security (CARES) Act states that providers can use the HHS Provider Relief Fund (PRF) dollars to cover "health care related expenses or lost revenues that are attributable to coronavirus." For June through August, HHS guidance stated that lost revenue could be measured one of two ways:

1) calculating the difference between budgeted and actual revenue for March and or...

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The DME MACS are hosting a joint webinar with the Part A/B MACS related to the accelerated and advance payment (AAP) programs. The webinar is applicable to those suppliers/providers that participated in the program. There are three opportunities to attend and ask questions. See below for more information.

Accelerated and Advance Payment Program Updates

This webinar is intended for Part A/B/DME providers and will include: 

•            ...

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The upcoming webinar “Competitive Bidding Round 2021 - Moving Forward with Uncertainty,” scheduled on Wednesday, Oct. 21 from 1 – 2:30 p.m., is being postponed to a later date. Our government and regulatory team anticipated some movement in implementation – or at least an update from CMS or the CBIC contractor – by this date.

Somewhat surprisingly, there has been none. The official timeline suggested a “Summer 2020” release of the single...

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Both Jurisdictions B and C CGS Medicare issued an update on October 15th related to the MUE claims processing alert. Read their article below for details:

Jurisdiction B & C News from CGS

MUE Claim Alert Issue - Claims in Process September 22-26 

ANSI Reason Code: CO-151 ANSI Remark Code: MA01 HCPCS Codes Impacted: Multiple

Some claims may have processed against Medically Unlikely Edit (MUE) values incorrectly. The MUE files were incorrect in our system on...

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Over twenty HME suppliers attended the virtual visit today with our industry champ, Rep. Cathy McMorris Rodgers. The event was hosted by Norco, PAMES, AAHomecare, Pride, and VGM.  

Attendees had the opportunity to address issues regarding budget neutrality (H.R.8158) and rural reimbursement (H.R.2771) legislation, which would delay the competitive bid program and telehealth.  

Everyone was able to express their sincere thanks to her...

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Have you heard that effective November 12, 2020, both the enteral nutrition and parenteral nutrition local coverage determination (LCD) and related policy articles (PA) are retiring? The DME MACs, CGS, and Noridian Medicare released the news on October 12.

What does this mean for you? 

For claims with dates of service (DOS) prior to Nov. 12, 2020, the LCD is applicable. 

For claims with DOS on or after Nov. 12, 2020, refer to the National Coverage...

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CGS Administrators recently sent out a news alert for Jurisdictions B and C. They aware of a claim payment issue in which some claims may have applied Medically Unlikely Edit (MUE) values incorrectly on the dates September 23, 2020 and September 24, 2020 only. Claims may have paid or denied in error as a result. CGS is correcting this issue and has indicated that it is a number 1 priority with them.  For more information, watch Ronda’s vlog. To view CGS’s original announcement,...

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