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Tag: audit


Specialty Providers

Large number of vets not receiving follow-up care for their sleep apnea, OIG says

January 29, 2020HME News Staff

WASHINGTON - The Veterans Health Administration is at risk of potentially spending $261.3 million over the next five years on sleep apnea devices and supplies that veterans will not use, according to the Office of Inspector General.Nearly half of the almost 114,000 veterans who were not consistently using their devices did not receive the necessary follow-up care, the OIG found.“Sleep medicine clinicians at VA medical facilities told the audit team they were unable to use available usage data...

audit, compliance, cpap, OIG, VA


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News

SMRC warns of audit risk—for ordering practitioners

January 7, 2020HME News Staff

ATLANTA - The SMRC is holding ordering practitioners accountable and acknowledging that provider payments for DMEPOS are reliant on their documentation, the van Halem Group reports.The requirement for practitioners to comply with a provider's request for documentation has been part of the Program Integrity Manual for some time, but in its most recent project detail for diabetic test strips, the SMRC says:“If a practitioner doesn't respond to a supplier's request for documentation to support...

audit, documentation, van Halem Group


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Also Noted

RAC targets pneumatic compression devices

January 29, 2019HME News Staff

ATLANTA - Performant Recovery, the national DMEPOS RAC, added pneumatic compression devices to its approved issues list on Jan. 23, the van Halem Group reports. Performant will perform complex reviews to determine if the pneumatic compression device is reasonable and necessary for the patient's condition based on the documentation in the medical record. Claims that do not meet the indications of coverage and/or medical necessity will be denied. The audit will cover E0651 and E0652 for claims having...

audit, pneumatic compression devices, RAC


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Vendors

ResMed's Farrell calls Q3 'strong'

April 27, 2018HME News Staff

SAN DIEGO - ResMed reported revenues of $591.6 million for the third quarter of fiscal year 2018, a 15% increase compared to the same quarter last year.It reported revenues of $317.5 million in the United States, Canada and Latin America, a 7% increase, and revenues of $39.9 million from Brightree, a 14% increase. It reported revenues of $234.2 million in Europe, Asia and other markets, a 16% increase.ResMed reported a net income of $110.1 million for the third quarter, a 25% increase compared to...

audit, earnings, ResMed


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Vendors

Invacare readies to submit final report to FDA

February 12, 2016HME News Staff

ELYRIA, Ohio - Invacare could be turning the corner on its “ongoing journey” to lift a consent decree with the Food and Drug Administration that has handicapped the company since late 2012.An independent auditor on Feb. 9 issued its certification report for the third phase of the decree, indicating Invacare's substantial compliance to the FDA's quality system regulation or QSR, Matt Monaghan, chairman, president and CEO, announced during a Feb. 11 conference call to discuss fourth quarter...

audit, consent decree, FDA, Invacare


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Mobility

Providers react to Hoveround audit

December 18, 2015Tracy Orzel

YARMOUTH, Maine - Mobility providers aren't surprised by the Office of Inspector General's call for Hoveround to pay back the federal government $27 million, they say.After auditing 200 randomly selected Hoveround claims for PMDs from 2010, the OIG found that 154 did not meet Medicare reimbursement requirements.“I'm in rural North Dakota and I've come across many beneficiaries that have a power wheelchair from Hoveround or The Scooter Store in their garage, closet or spare bedroom that they've...

audit, Hoveround, OIG


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Also Noted

AAH set to take HME Audit Key live

December 18, 2015HME News Staff

WASHINGTON - The HME Audit Key goes live in January, AAHomecare has announced. The association is asking providers to register for the tool now and get ready to enter their fourth quarter 2015 audit data into the tool in the second half of January. “The HME community must be able to better demonstrate the burdensome nature of audits, in terms of volumes and overturn rates,” AAHomecare stated. “Your participation will help the industry gather the data we need to make the case for...

aahomecare, audit, data


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News

Audit bill clears committee

June 4, 2015HME News Staff

WASHINGTON - The Senate Finance Committee on Wednesday passed a bill to improve the Medicare audit and appeals process.The bill, the “Audit and Appeal Fairness, Integrity and Reforms in Medicare Act” or AFIRM Act, was co-authored by Sen. Orrin Hatch, R-Utah, chairman of the committee, and Sen. Ron Wyden, D-Ore., ranking member.“This is a common sense bill that will help untangle the web of red tape that ensnares the current audit and appeals process and guarantee Medicare patients...

audit, legislation, reform


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News

Connolly snags contract for DME-specific RAC

January 6, 2015HME News Staff

WASHINGTON - CMS has awarded a national contract to identify overpayments specifically for DME, home health and hospice to Connolly, the agency announced Dec. 30.CMS announced its plans to create a fifth recovery audit contractor (RAC) back in 2013.Wilton, Conn.-based Connolly is already the RAC for Jurisdiction C, the largest of the four jurisdictions.Along with the RAC, CMS will implement a number of improvements to its audit program, including requiring the RACs to wait 30 days before sending...

audit, Connolly, RAC


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News

CMS to contractors: Wait until enforcement to audit

September 2, 2014HME News Staff

WASHINGTON - CMS has instructed its contractors not to retrospectively audit providers for compliance with the face-to-face requirement.The news comes via an Aug. 20 letter sent by CMS Administrator Marilyn Tavenner to Rep. David Roe, R-Tenn., who inquired about audit activities related to the requirement after meeting with members of ATHOMES.“The delay in enforcement on the face-to-face encounter requirements applies to reviews conducted by the DME MACs, Recovery Auditors, the Zone Integrity...

audit, enforcement, face-to-face requirement


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