Tag: CPAP Bundling

WASHINGTON - Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.As part of an expanding “Targeted Probe and Educate” program, the Medicare Administrative Contractors will identify these providers through data analysis.“TPE claim selection is different from that of previous probe and educate programs,” the agency stated in an Aug. 14 announcement...

WASHINGTON - CMS does not have the authority to implement bundled bidding programs for CPAP or other HME, because it would jeopardize patient access to specific equipment, say industry stakeholders.Bundling a CPAP device, consumable items, maintenance and service into a single monthly payment will cause disruption for suppliers and will provide an incentive to furnish inferior products and provide a lower quality of care to compensate for shrinking margins, said AAHomecare in its weekly newsletter.Additionally,...

WASHINGTON - Providers don't know what to make of CMS's plan to implement bundled payments for CPAP, but say they doubt it's a good thing.“There's nothing to go by yet, but the sheer concept is counterintuitive as far as patient care,” said Chris Rice, CEO of Riverside, Calif.-based Diamond Respiratory Care. “We want to keep them compliant and keep good supplies on them, but now we are flipping the coin and creating an incentive to provide fewer supplies.”CMS has yet to release...