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Improvements to the Adjudication Process of Serial Claims

By Kelly Grahovac, The van Halem Group A major win for DME suppliers was announced yesterday (Thursday), as CMS released information regarding improvements to the adjudication process of serial claims. Effective April 7, 2017, CMS has implemented changes to improve the processing and adjudication of recurring (monthly) claims for capped rental and certain inexpensive and

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Inside Health Policy article discusses current issues with Oxygen reimbursement

In 2017, CMS incorrectly applied a budget neutrality “offset” to 2017 rural fee schedules for oxygen concentrators. This led to an improper reduction in reimbursement for HCPCS E1390 by an additional 11 percent on average. This forced reimbursement rates in rural areas below the average regional competitive bidding special payment amounts (SPA). Below is an

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From the Reimbursement Team: Medicare Establishes Set Fees for Custom Cushions (E2609) and Backs (E2617)…. and it DOESN’T Sit Well!

This is a heads up to those who provide custom cushions (E2609) and backs (E2617) to Medicare beneficiaries! The Jurisdiction B and C DME MAC has decided to develop set fees for these custom items and did this internally without notice to the provider community. As of today DME A and D has NOT implemented this change.

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Attend AAHomecare’s Washington Legislative Conference

Providers and industry stakeholders have been working non-stop since the first gavel of the 115th Congress to advocate for DMEPOS suppliers and the patients that they serve. We encourage anyone that is able, to attend the AAH Washington Legislative Conference and meet with your members of Congress and let your voice be heard. This year’s

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NEMEP names Beth Bowen as new Executive Director

In a press release Tuesday afternoon the recently formed Northeast Medical Equipment Providers Association (NEMEP), made up of New York and New Jersey supplires, announced that Beth Bowen has been selected to lead the association. Bowen and her group, TayCar, Inc. currently manages, ACMESA, FAHCS, and ATHOMES, in addition to NEMEP. “How exciting it is

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Play a direct role in reforming competitive bidding – Submit your data now!

With the new administration settling in, and the Department of Health and Human Services (HHS) leadership starting to evaluate programs of the previous administration, there are few better times to make the case for reform. In order for the competitive bidding program to improve patient access to durable medical equipment, things must change. In order

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Submit Your Comments to CMS on Competitive Bidding by April 6th

For those who have not submitted comments yet to CMS on the impacts of competitive bidding to your business, be sure to submit them by April 6 to be considered. CMS is mandated to solicit and take into account stakeholder input related to adjustments of fees paid in non-competitive bidding areas beginning in 2019. CMS

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Providers share input to CMS on the impact of competitive bidding

Providers from across the country dialed in to a phone call this afternoon to hear directly from the agency on developments stemming from the Cures Act, and to provide input for future rounds of competitive bidding. The call was well attended and XX different providers having the opportunity to share how the competitive bidding program

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Opinion piece in The Hill outlines competitive bidding impacts on rural beneficiaries.

Last week in The Hill, industry thought leader, Peter Thomas composed an opinion piece that outlined the many problems that patients in rural America are facing due to highly flawed programs. Addressing both the durable medical equipment and complex rehab industries, Thomas outlines the great need for policy change in order to protect access for

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