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audits

Advocate at every level

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02/22/2019

LAS VEGAS - Audits aren't going away, but providers who are proactive vs. reactive will see better results, says Juliet McBride, partner at King & Spalding LLP.

CMS tweaks TPE program

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01/08/2019

WASHINGTON – CMS on Dec. 31 implemented the “TPE 10-Claim Preview Pilot” to help reduce the burden for compliant DME providers, AAHomecare reports.

OIG to CMS: Collect Medicaid overpayments

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12/12/2018

WASHINGTON – CMS did not collect $1.6 billion in Medicaid overpayments in 77 current period audits and $188.6 million in seven prior period audits, according to a new report from the Office of Inspector General.

Stakeholders slam self-audits

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10/12/2018

WASHINGTON – A recent request by the DME MAC contractors for certain CPAP providers to audit themselves is setting them up to fail, say industry stakeholders.

van Halem: ‘Aggressive’ UPICs take over

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09/24/2018

ATLANTA – It’s time for HME providers to reacquaint themselves with the Unified Program Integrity Contractors, or UPICs, says Wayne van Halem.

Enteral nutrition, surgical dressings top error list

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05/15/2018

WASHINGTON – Enteral nutrition had the highest error rate (87%) from Targeted Probe and Educate audits in Jurisdiction D.

Judge getting impatient with HHS over massive ALJ backlog

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Friday, April 6, 2018
Elizabeth Hogue

I recently wrote an article entitled "Court Says No Recoupment Until After ALJ Hearings."  This article was about a court decision in which the judge said that recoupment of an extrapolated overpayment as a result of a ZPIC audit could not begin until after ALJ hearings were held.

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‘It is no longer worth the pit in my stomach’

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Wednesday, April 4, 2018

It’s always disappointing when the HME industry’s efforts to get relief from Medicare’s competitive bidding program fail to cross the finish line. But this last time around, when H.R. 4229 failed to make the cut in a recently passed omnibus bill, it was particularly disappointing.

Noridian named new SMRC contractor

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03/23/2018

FARGO, N.D. – Noridian Healthcare Solutions has been awarded a $227 million Supplemental Medical Review Contractor (SMRC) contract by CMS. The primary role of the SMRC is to conduct nationwide medical review of Part A, Part B and DME providers as directed by CMS.

New audit software helps to identify potential problems

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12/29/2017

FORT LAUDERDALE, Fla. – It’s no secret that audits, and all the administrative complexities that accompany them, have been the bane of the HME industry for years. But a recently formed partnership between HME stakeholders aims to change that.

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