Category Posts

Listen below as Ronda Buhrmester breaks down the new prior auth list, requirements, and the phases to implementation. 

Click here for the update master list of items subject to face-to-face and WOPD and/or prior auths.

And register for Ronda’s upcoming Live Chat, Wednesday, January 20th at 11am central as she covers PHE waivers, and disects the new master list. Register for her Live Chat! Seats are limited!

 

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While it is true that our industry, and all industries for that matter, face challenges on several fronts, we should take stock in the amazing service, support, and products that our community was able to provide to those in need! Your focus on the patient was never more needed, and each of you rose to the challenge. As you battle through supply shortages, uncertain healthcare policies, public health emergencies, and crazy weather in multiple regions across the county, you continue to...

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Watch this latest vlog from Ronda Buhrmester, Sr. Director of Payer Relations, as she walks through how to find the CMS DMEPOS fee schedules and more!

Long awaited with keen interest by industry stakeholders, CMS released on December 21, 2021 its final rule (CMS-1738-F) relative to post-pandemic DMEPOS fee schedule adjustments, in addition to making certain benefit category and payment determinations for new items, classification of adjunctive continuous glucose monitors as DME under Medicare Part B and finalized certain DME payment provisions that were included in two interim final rules (CMS-1687-F and CMS-5531-F).

However, the main...

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We are sharing this message on behalf of the Great Lakes State Association on actions needed for those who serve in the state of Indiana.

From Great Lakes President Chuck Williams and Exec. Director Kam Yuricich:

We are pleased to report that Great Lakes Indiana leadership has been working with HME champions in the Indiana state legislature to educate them on the issues HME providers are facing in the Medicaid managed care program. This has led to the development of a bill that...

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President Biden Signs Legislation Averting PAYGO and Sequester Cuts from Taking Effect at the Beginning of 2022 

Late last week, President Biden sign S.610, the “Protecting Medicare and American Farmers from Sequester Cuts Act,” which delays implementation of the additional 4% reduction in reimbursement for Medicare providers and suppliers (PAYGO) as well as the 2% reduction in Medicare sequestration cuts. This includes:

No payment adjustment through...

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Yesterday, the Senate passed S.610 - Protecting Medicare and American Farmers from Sequester Cuts Act, delaying implementation of an additional 4% reduction in reimbursement for Medicare providers and suppliers as well as the 2% reduction in Medicare sequestration cuts. Congress had deferred the cuts during the COVID-19 public health emergency, but the deferral is scheduled to expire at the end of this...

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Watch Ronda Buhrmester’s latest vblog below on audits for surgical dressings. Click here to view the notification from Noridian or go to https://www.noridiansmrc.com/current-projects/01-303/.

For more information, you can reach out to Ronda at 217-493-5440 or [email protected]

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November 13th CMS announced that Medicare Part B premiums and deductibles will see the largest hike in the program's history next year.

Seven issues of concern…

The CMS rule boosts the standard Medicare Part B premium to $170.10 a month, up $21.60, or 14.5 percent. It also increased Part B standard deductibles by $30, up 14.8 percent to $233 in 2022
  The increase translates to nearly $14,000 in annual costs for the wealthiest senior couples.
  Despite...

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Yesterday, CMS sent out the alert below regarding the recalled Phillips Respironics products, directing Medicare beneficiaries to reach out the suppliers they purchased the equipment from if they need it replaced or repaired. While the statement released by CMS is accurate in that most of the patients impacted by the recall should expect to have their existing device repaired or replaced, it fails to mention that the process and timeline associated with repairing or replacing those devices could...

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