Tag: Elizabeth Hogue
Audit round up: RACs cut checks, UPICs run roughshod
June 28, 2019Theresa Flaherty, Managing Editor
YARMOUTH, Maine - Nearly two years after Performant Recovery announced it would perform an underpayment review for Group 3 power wheelchair options, providers are receiving refund checks, says Andrea Stark.
Performant, the DMEPOS RAC, announced in May 2017 it would review wheelchair accessories, including seating systems, and seat and back cushions furnished in conjunction with codes K0848—K0864 for the six-month period of Jan. 1, 2016—June 30, 2016. The review was necessary because...
Simply Home sues HHS over overpayments
April 18, 2019HME News Staff
CHICAGO - Simply Home Health Care, a home health agency based here, has filed a lawsuit in the U.S. District Court for the Northern District of Illinois against the Department of Health And Human Services and AdvanceMed, a UPIC, for continued suspension of payments from the Medicare program, according to healthcare attorney Elizabeth Hogue. Payments to Simply Home were originally suspended because of overpayments, but the agency was later told by AdvanceMed that payments were suspended because of...
New court decision on recoupments
February 15, 2019Liz Beaulieu, Editor
WASHINGTON - Healthcare attorney Elizabeth Hogue has been watching closely as numerous courts go back and forth on whether or not CMS should be stopped from recouping overpayments until after the ALJ level, but she thinks a recent court's decision is “really serious.”
Here's what Hogue had to say about a Florida district court's decision to deny a home health agency's request for a preliminary injunction to stop recoupments before an ALJ hearing on the grounds that...
New RACs and new rules
November 2, 2016HME News Staff
CMS has selected five new recovery audit contractors (RACs) and established new rules. RAC audits will undoubtedly resume soon. Performant and Cotiviti were awarded contracts, along with HMS Federal Solutions. A previous RAC auditor, CGI Group, did not bid in the latest round of contracts for RACs. Performant will focus on auditing home medical equipment (HME), home health agency (HHA) and hospice claims.
CMS will continue to pay RAC auditors a contingency fee when overpayments are identified....
What's to learn from Wells Fargo?
October 14, 2016Tracy Orzel
YARMOUTH, Maine - Banking giant Wells Fargo is under fire from consumers and Congress for setting such high sales goals, employees felt pressured to create sham accounts. The controversy has shined a light on how companies set up their sales program.Luckily, the banking and healthcare industries aren't one in the same, says healthcare attorney Elizabeth Hogue.“Wells Fargo got dinged, but HME suppliers should have checks in place to prevent submission of bogus claims,” she said.That's...
Create 'open culture' to address employee complaints
August 7, 2015Theresa Flaherty, Managing Editor
YARMOUTH, Maine - Healthcare attorney Elizabeth Hogue says she's mystified that whistleblower claims filed by employees or former employees aren't met with more skepticism by law enforcers.
“They feel that if an insider says it, it must be true,” said Hogue. “It seems to me there are plenty of disgruntled insiders or insiders who don't have all the information.”
Traditionally, whistleblower claims are based on false or lack of documentation, kickbacks, and...
Beware these pitfalls of acute, post-acute care alignment
March 13, 2015Liz Beaulieu, Editor
BURTONVILLE, Md. - Sure, the push by hospitals and health systems to reduce readmission rates has created opportunities for post-acute care providers. But post-acute providers should be careful not to take on too much responsibility, says healthcare attorney Elizabeth Hogue. Here's what Hogue had to say about navigating the Wild West of acute and post-acute care alignment.HME News: As post-acute providers seek to create partnerships with hospitals and health systems, what are the pitfalls they face?Elizabeth...
Include benchmarks in agreements
February 21, 2014Liz Beaulieu, Editor
Under tremendous pressure to reduce readmission rates, hospitals are more open than ever to establishing preferred provider agreements with HME providers, says healthcare attorney Elizabeth Hogue. “Providers need to understand them and actively pursue them,” she said. Here's what Hogue had to say about the elements of successful agreements, including benchmarks, the topic of a webcast she hosted Feb. 13.
HME News: Why are these agreements becoming increasingly attractive?
Elizabeth...
Opinion greenlights post-discharge services
October 18, 2013Liz Beaulieu, Editor
WASHINGTON - An advisory opinion from the Office of Inspector General (OIG) provides a framework for how HME providers can offer services to reduce hospital readmissions without violating the anti-kickback statute.
The biggest takeaway: Providers cannot supply these services to hospitals for free.
“The hospital has to pay,” said Elizabeth Hogue, a private practice attorney in Burtonville, Md. “That was crucial to the OIG's approval.”
Advisory Opinion No. 13-10...
HME Talk says 98% of providers like HME News best
March 30, 2010Mike Moran
This is flattering and came out of the blue. Earlier this month HME Talk (no relation to HME News) asked its members what industry publication (HME News, Homecare Magazine or HME Business) they read the most.
Guess what? We won.
Here's what HME Talk (an online discussion board, blog, etc.) wrote a week after it posted the survey:
HME News is Tops on Survey
While hardly scientific, our survey last week asking HME Talkers which publications they read (HME News, Homecare Magazine, and HME Business),...