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Settlement update: A non-option option for appeals

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12/08/2017

WASHINGTON – CMS has rolled out a new settlement option for low-volume appeals, but it’s not likely HME providers will take the agency up on its offer, stakeholders say.

In brief: Invacare reduces workforce, Gilligan replaces Diamond at Drive

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12/08/2017

ELYRIA, Ohio – Invacare will reduce its workforce by about 110 employees to generate $8.5 million in pre-tax savings, the company announced Dec. 7.

Growth in health spending slows

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12/07/2017

WASHINGTON – National health spending increased 4.3% in 2016 compared to 5.8% in 2015, according to a new study by the Office of the Actuary at CMS.

As CMS rolls out details, eyes turn to Medicaid

‘The states have to ensure access to care, so they have the right to set rates to whatever they need to’
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12/01/2017

WASHINGTON – CMS has finally started to detail how it plans to implement a provision in the 21st Century Cures Act that requires the agency to cap its contribution to Medicaid reimbursement for DME at Medicare reimbursement starting Jan. 1, 2018.

Stakeholders: We’re monitoring MedPAC

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12/01/2017

WASHINGTON – The Medicare Payment and Advisory Committee offered a mixed bag of observations about the competitive bidding program at a recent meeting, but they likely won’t lead to any significant changes, say industry stakeholders.

MCO readies for drastic cuts in Illinois

‘They assume we’re just going to be silent and take it’
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12/01/2017

SPRINGFIELD, Ill. – IlliniCare Health Plan may be only one Medicaid managed care organization with plans to drastically cut payments for DME in only one state, but when its parent company is Centene Corp., which has MCOs in 28 states, HME providers everywhere take notice.

In brief: HHS details status of appeals backlog, supplier dropped from lawsuit

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12/01/2017

FALLS CHURCH, Va. – The Office of Medicare Hearings and Appeals receives more than a year’s worth of appeals work every 24 weeks at the third level of appeals, according to a recent PDF posted to the agency’s website.

HHS details status of appeals backlog

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11/29/2017

FALLS CHURCH, Va. – The Office of Medicare Hearings and Appeals receives more than a year’s worth of appeals work every 24 weeks at the third level of appeals, according to a recent PDF posted to the agency’s website.

CMS starts implementation process for Cures provision

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11/28/2017

WASHINGTON – CMS wants state Medicaid programs to submit their DME fee schedules using a new spreadsheet to make sure they’re not paying too much for equipment, according to a notice in the Federal Register.

Be prepared for your day before ALJ hearing

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11/21/2017

ATLANTA – Many HME providers end up in front of an administrative law judge (ALJ) to contest a reimbursement denial, but too often they don’t know what they’re up against.

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