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Vlog: Update to Prior Auth List and F2F/WOPD Requirements
January 13, 2022
Categories: CMS, General, Medicare, PHE
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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CMS Releases (CMS-1738-F) Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Final Rule
December 22, 2021
Categories: CMS, General, Medicare
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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CMS Announces Largest Hike in Medicare Part B Premiums and Deductibles in the Program's History
November 15, 2021
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... Read More -
CMS Directs Beneficiaries to Reach Out to Their Suppliers for Repair and Replacements of Phillips Respironics Recalled Equipment
August 26, 2021
Categories: CMS, General, Medicare, PRI
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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Senate Passes Delay of Medicare Sequestration Cuts
March 25, 2021
Categories: General
Today the Senate voted to delay Medicare payment cuts for the rest of the year, a big win for HME providers and hospitals!
The 2% cuts originally took effect in 2013 but were paused by Congress last year in response to the pandemic and its effect on providers' finances.
This legislation now will head back to the House for passage...
Read MoreHHS Opens New Portal for Providers to Submit Claims
April 30, 2020
Categories: COVID-19, General, Reimbursement
This week HHS opened a new portal which allows providers, including DME providers, to submit claims to be reimbursed at Medicare reimbursement rates if they provided equipment and services to uninsured patients with a COVID-19 diagnosis. Some key highlights and provisions of the program are as follows:
Providers can begin submitting claims May 6th Dates of service can be February 4th or after are eligible for reimbursement Providers must enroll in the program (obtain an Optum... Read MoreTake action today! Binding Bids Bill will likely be re-introduced.
January 8, 2015
Categories: Audits, Competitive Bidding
As reported by AA Homecare, representatives Pat Tiberi (R-Oh) and John Larson (D-CT) and senators Rob Portman (R-OH) and Benjamin Cardin (D-MD) are planning on reintroducing the binding bids bill as early as next week. The binding bid bill (HR 4920 and S2975 in the 113th Congress), would require a proof of licensure before a suppliers can bid. It would also require a supplier to obtain a bid bond. Please find time today to message your senator and member of Congress to support any binding bid language...
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