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audits

CMS sets start date for targeted audits

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09/22/2017

WASHINGTON – CMS will expand its Targeted Probe and Educate program to include all of the Medicare Administrative Contractors effective Oct. 1.

Providers to SBA: Monitoring clipboards won’t curb fraud

‘The new administration is asking how to get rid of the regulations’
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09/01/2017

WASHINGTON – From accreditation to audits, HME providers let panel members at a Small Business Administration hearing last week know exactly how they feel about burdensome regulations.

Reporter’s notebook: Audit reprieve a ‘confidence builder’

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08/28/2017

MODESTO, Calif. – It’s not every day that HME providers get good news from a CMS audit contractor, but Home Oxygen Company recently got a break from certain audits.

New audit program makes concessions

Puts emphasis on education, rewards improved performance
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08/25/2017

WASHINGTON – HME stakeholders and billing consultants are “cautiously optimistic” about a new program aimed at streamlining the number of audits.

Regulatory news: CMS revamps audits, lawmakers question CPAP bundling

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08/18/2017

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.

In brief: HHS scores win in appeals fight, Superior HealthPlan makes changes to Medline contract

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08/18/2017

NEW YORK – The D.C. Circuit on Aug. 11 ordered a federal judge to take a deeper look at whether or not the U.S. Department of Health and Human Services can clear a backlog of about 600,000 appeals by 2021, while still protecting taxpayer dollars, according to Law360.

CMS revamps claims review process

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08/16/2017

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.

Hot in the Heartland

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Wednesday, June 14, 2017

There’s an old saying: If you can’t take the heat, get out of the kitchen.

Senate committee prioritizes audit, appeals reform

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05/26/2017

WASHINGTON – Forcing Medicare to better coordinate audits and improve the appeals process is one of the top priorities of the Senate Finance Committee this year, Kimberly Brandt told attendees at the AAHomecare Washington Legislative Conference on Wednesday.

Appeals backlog wears on

‘Hopefully we’re still in business when our cases get to a judge,’ says provider Donna Barraclough
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05/19/2017

YARMOUTH, Maine – A whopping 92% of respondents to a recent HME Newspoll say they have claims stuck at the administrative law judge level and are waiting—and waiting—for hearing dates.

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