Tag: DME MACs

YARMOUTH, Maine - Industry stakeholders are weighing the recent shake up in the DME MACs.For the first time ever, there will be two contractors handling claims processing for all four jurisdictions: CGS Administrators and Noridian Healthcare Solutions.“This is definitely a big change,” said Wayne van Halem, president of The van Halem Group. “The four jurisdictions have been around since 1993 and there have always been four unique companies doing it. (CGS and Noridian) have become...

WASHINGTON - The DME MACs have issued a policy reminder to providers about CPAP therapy after a review of recent appeals identified denials associated with lack of compliance with requirements for continued coverage after the first three months of rental. At the end of the initial rental period, additional requirements must be met for rental and payments to continue: the treating physician must meet the beneficiary in person between the 31st and 91st days after initiating therapy for a re-evaluation...