CMS tweaks TPE program
By HME News Staff
Updated Tue January 8, 2019
WASHINGTON - CMS on Dec. 31 implemented the “TPE 10-Claim Preview Pilot” to help reduce the burden for compliant DME providers, AAHomecare reports.
Per the pilot, the MACs may select 10 claims for review under Round 1, and if a provider is found to be compliant for a service/item, the NPI associated with those 10 claims will be exempt from reviews for about one year for that service/item. If errors are detected, a provider will go through the usual TPE process.
AAHomecare says information on the pilot will be available on CMS's website soon.
In addition, CMS has also published a new transmittal instructing the MACs to review only services/items with dates of service after one-on-one education for Rounds 2/3, whereas they can review dates of service or dates of submission for Round 1. The MACs must allow 45-56 days between each education intervention to give suppliers time to improve.
The change applies to any new edits for Round 2/3 put in place after the Nov. 28 transmittal.
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