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In brief: CMS limits scope of audits, O&P fight rages on


WASHINGTON – For redeterminations and reconsiderations of claims denied following a post-payment review or audit, CMS has instructed the MACs and QICs to limit their scope to the reason the claim or line item was initially denied, according to a recent MLN Matters

A horse is a horse of course, but Ladybug knocked her rider off course

Thursday, September 3, 2015

My friend Danielle, a long-avowed animal lover, has been taking horseback riding lessons for the past year or so. In August, she finally realized her dream of owning her very own horse, a rehabbed mustang named Ladybug (she didn’t pick the name).

Prosthetic community ups ante

‘Get your hands off my legs’

LINTHICUM, Md. – O&P stakeholders commented at a public hearing, staged a protest and participated in a high-stakes meeting with CMS, all in one day, in their bid to reverse proposed coverage changes for lower limb prostheses.

In brief: Senate readies letter on accessories, Sunrise adds ‘complementary’ biz


WASHINGTON – The deadline has been extended until Aug. 10 for senators to sign on to a letter asking CMS to continue paying for accessories for complex rehab wheelchairs at the fee schedule, not the competitive bidding, rate.

O&P groups push back on LCDs


ALEXANDRIA, Va. – The National Association for the Advancement of Orthotics and Prosthetics has launched a petition asking the White House to rescind proposed coverage changes for prostheses.

Lawmakers weigh in on O&P

‘Get this done,’ agrees AOPA

WASHINGTON – Lawmakers recently sent a letter to CMS demanding the agency enforce long-established O&P licensure and certification requirements.

3-D technology intrigues prosthetists

‘In today’s world of technology, you’ve got to be looking at just about everything,’ says one provider

YARMOUTH, Maine – It sounds like something out of a sci-fi film: artificial limbs rolling off a 3-D printer.

Bill raises standards for O&P


WASHINGTON – Sens. Chuck Grassley, R-Iowa, and Mark Warner, D-Va., introduced a bill on March 23 that would apply accreditation and other standards for orthotics and prosthetics to help guarantee product quality and reduce fraud in the Medicare program.

OIG finds inappropriate payments to prosthetic provider


WASHINGTON – A report from the Office of Inspector General found that San Antonio, Texas-based Prosthetic Science has received $25,125 in inappropriate Medicare payments.

CMS updates O&P edits


BALTIMORE – CMS has instructed the DME MACs to update programming edits that deny claims for prosthetics and certain custom orthotics when they are furnished by personnel who are not certified orthotists or prosthetists in states where that is a requirement, ac