Tag: Reimbursement
Ventilation: Embrace your inner expert
October 6, 2026Boone Lockard
Q: With the new ventilation NCD placing greater emphasis on clinical involvement, how should providers think about reimbursement and their relationships with referral sources moving forward?
A: The new NCD is changing more than reimbursement requirements. It's changing how providers are viewed within the patient care continuum.
Historically, some referral sources may have viewed the provider's role as largely transactional: delivering equipment, providing setup and managing fulfillment....
Stephanie Robinson on the art of digging into denials
September 18, 2026Tracy Orzel
WATERLOO, Iowa – HME providers that treat a billing failure as an isolated problem may fix a claim and recover a payment. But only by tracing the failure backward can they fix the system, says Stephanie Robinson, VGM’s new director of reimbursement and payer relations.
HME News: Where are providers struggling most with billing and reimbursement?
Stephanie Robinson: I think selecting the correct payer has always been a struggle for all suppliers because there's so much downstream...
AMA survey finds barriers to wearable data adoption
July 9, 2026HME News Staff
CHICAGO – While interest in wearable health technologies is high, their integration into routine clinical care continues to be limited by workflow, reimbursement and trust issues, according to a new international survey from the American Medical Association (AMA). The 2026 International Physician Survey on Consumer Wearables, conducted by the AMA’s Center for Digital Health and AI and Medscape, surveyed 2,222 physicians in the United States, Canada, France, Germany, Spain and the United...
VGM names new billing and reimbursement director
June 8, 2026HME News Staff
WATERLOO, Iowa – VGM & Associates has appointed Stephanie Robinson, who has held leadership roles at Dynamic Healthcare Services, as director of billing and reimbursement. She will work closely with VGM members to improve reimbursement processes, address operational challenges and improve performance. “Billing and reimbursement are among the biggest operational pressures providers are managing today, and Stephanie brings the real-world experience to help our members work through those...
Cheelcare secures Medicare reimbursement for power assist device
January 27, 2026HME News Staff
MARKHAM, Ontario – Cheelcare has received Pricing, Data Analysis and Coding (PDAC) verification for its Companion power assist device, confirming reimbursement eligibility for Medicare and Medicaid under HCPCS code E0986. Historically, adoption of Companion has been primarily concentrated within Veterans Affairs (VA), vocational rehab and workers compensation programs. Medicare and Medicaid reimbursement represents a significantly larger addressable market,...
New York Medicaid increases access to standing frames
March 10, 2025HME News Staff
NEW YORK – HME stakeholders in New York have worked with the state’s Medicaid program to secure reimbursement increases for standing frame / table systems that support children with neuromuscular conditions that impair their ability to stand independently. Reimbursement for E0638 is now $3,264.65, up from $1,285.95; and reimbursement for E0641 is $3,526.92, up from $1,680.52. “New York’s children with profound medical needs now have access to the most medically appropriate...
Bill’s sponsors on Medicare cut: ‘The future of private practice is in dire straights’
February 3, 2025HME News Staff
WASHINGTON – A bipartisan group of 10 lawmakers in the House of Representatives has introduced a bill to stop the 2.83% cut in Medicare payments to stabilize physician practices and protect access to care.
The “Medicare Patient Access and Practice Stabilization Act,” introduced by Reps. Greg Murphy, M.D., R-N.C., and Jimmy Panetta, D-Calif., along with eight other House members, would prospectively cancel the 2.83% cut that went into effect Jan. 1.
“Physicians...
NCPA joins price-fixing lawsuit
January 27, 2025HME News Staff
ALEXANDRIA, Va. – The National Community Pharmacists Association has joined a class action lawsuit against GoodRx, as well as CVS Caremark, Express Scripts, MedImpact Healthcare Systems and Navitus Health Solutions, that accuses them of colluding in a scheme to fix reimbursement rates to independent pharmacies. The lawsuit, brought by Community Care Rx, an independent pharmacy in Michigan, alleges that GoodRx and several PBMs are violating federal antitrust law by sharing competitively sensitive...
Patient advocacy groups press leadership on reimbursement relief
December 4, 2024HME News Staff
WASHINGTON – More than 30 leading patient advocacy organizations have weighed in with congressional leadership to support including provisions from H.R. 5555 and S. 1294 in any legislative package that moves before the end of the year, AAHomecare reports.
In a Dec. 2 letter from the ITEM Coalition, the groups assert that the expiration of 75/25 blended Medicare reimbursement rates on Jan. 1, 2024, has resulted in a “crushing blow to DMEPOS suppliers and providers, threatening...
Report makes case for ‘fully funding’ DME
September 24, 2024HME News Staff
WATERLOO, Iowa – The cost of treating injuries and illnesses due to lack of DME far exceeds the cost of providing the necessary equipment, according to a new report from Leitten Consulting.
For example, every dollar spent on mobility equipment can save Medicare $62.53 in treatment costs, the report found.
“An ounce of prevention is now worth several pounds of cure,” said Brian Leitten, CEO of Leitten Consulting, which specializes in health care policy analysis...