Briefs: Oxygen errors remain high

Thursday, November 10, 2011

FARGO, N.D. - Oxygen claims for E1390 and E0431 have an overall error rate of 66% in Jurisdiction D for the third quarter, according to a March 14 bulletin from DME MAC Noridian Administrative Services. That's down from 67% in the second quarter and up from 54% for the first quarter. "Because the error rate remains high, NAS will continue with the widespread complex review," the bulletin stated.

CMS plans upgrades to complaint process

WASHINGTON - CMS has resolved the majority of complaints and inquiries received through its 1-800-HHS-TIPS hotline, says the Office of Inspector General (OIG). Only 12% remain unresolved after one year. The OIG recommends that: "CMS (1) issue written guidance to its own staff and contractor staff for processing hotline complaints and (2) upgrade its information system for processing complaints."

OIG lobbies for 13-month oxygen cap

WASHINGTON - The Office of Inspector General (OIG) in March released a "Compendium of Unimplemented Recommendations" that includes changes that it believes would result in cost savings and/or program improvements if implemented. One recommendation: That CMS should work with Congress to reduce the rental period for oxygen equipment from 36 months to 13 months. The OIG estimates such a move would save $3.2 billion.

New owner for Jurisdiction C MAC 

NASHVILLE, Tenn. - Cigna Government Services, the Jurisdiction C DME MAC, has been acquired by BlueCross BlueShield of South Carolina, according to a March 28 announcement. CGS's name will change, but all current employees will remain in place. CGS processes and pays Medicare claims for more than 14 million beneficiaries and more than 100,000 providers. 

Still no start date for PECOS edits

BALTIMORE - CMS has not determined when it will begin to apply edits to claims from ordering/referring providers who do not have a record in PECOS. The OIG, in its "Compendium of Unimplemented Recommendations," released earlier this month, stated that it would begin implementing edits on July 5, 2011.