Tag: Documentation
In brief: Palladium invests in DME Express, CMS adopts e-standards, MFCU racks up cases
March 23, 2026HME News Staff
NEW YORK and THE WOODLANDS, Texas – Palladium Equity Partners has announced an agreement to acquire a majority equity interest in DME Express, a provider of durable medical equipment (DME) serving hospice providers across the U.S., from WayPoint Capital Partners, which will maintain a minority equity interest.
Palladium, which has more than $3 billion in assets under management, expects to partner with CEO Mark Borneleit and his founding team to continue to lead the business.
"DME...
In brief: Health care spending, prior auth list, fraud division
January 16, 2026HME News Staff
WASHINGTON – Health care spending in the U.S. reached $5.3 trillion and increased 7.2% in 2024, similar to 7.4% in 2023, as increased demand for health care influenced this two-year trend, according to a new article in the journal Health Affairs.
Health care spending growth continued to outpace overall economic growth
As a result, the health care share of the economy increased from 17.7% in 2023 to 18% in 2024. In 2024, the share of...
In brief: Bid fight’s next phase, Numotion’s LMN Navigator, Apple’s new sleep feature
September 12, 2025HME News Staff
WASHINGTON - AAHomecare has budgeted more than $3 million for a campaign to address the restart of the competitive bidding program.
The association will draw the funds for the campaign from its reserves and new fundraising efforts. Already, VGM and 21 other AAHomecare members have pledged more than $750,000. AAHomecare will expand solicitation efforts in the coming weeks.
“If the bidding program starts up again using the flawed framework and expanded product mix...
In brief: Vent correction, Medtrade ‘Insider,’ documentation update
October 9, 2024HME News Staff
CAMBRIDGE, Mass. – Philips Respironics has issued a voluntary correction for Trilogy Evo, Trilogy Evo O2, Trilogy Evo Universal and Trilogy EV300 ventilators regarding the use of in-line nebulizers.
The company has determined that, in some circumstances, the use of in-line nebulizers placed in certain locations may lead to aerosol deposits forming over time on the ventilator flow sensor. Should this occur, there is a possibility of patient impact due to one or more of the following...
Noridian updates medical records requirements
October 7, 2024HME News Staff
WASHINGTON – In the event of a claim review, information contained directly in the contemporaneous medical record is the source required to justify payment, except as noted elsewhere for prescriptions, according to an update posted by Noridian Healthcare Solutions. The medical record is not limited to records from treating physician/practitioner offices but may include records from hospitals, nursing facilities, home health agencies and other health care professionals. Records from suppliers...
In brief: Sign-on letter for oxygen, BOC’s Certificant of the Year
July 19, 2023HME News Staff
WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.
The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted oxygen...
Reps. Sewell, Smith launch sign-on letter to protect access to oxygen
July 17, 2023HME News Staff
WASHINGTON – Reps. Terri Sewell, D-Ala., and Adrian Smith, R-Neb., are collecting signatures for a sign-on letter asking CMS to accept the standard written order as the only necessary documentation to establish medical necessity for audits of home oxygen, sleep and non-invasive ventilation claims submitted during the public health emergency, according to AAHomecare.
The letter asks CMS to protect patient access by instructing contractors to use CMS’s widely accepted...
CMS expands required list
January 17, 2023HME News Staff
WASHINGTON – CMS has added 10 more HCPCS codes to a required list for a face-to-face encounter /written order prior to delivery, according to VGM Government Relations.
The new codes include the following for back, knee and ankle/foot braces: L0631, L1843, L1932, L1940, L1951, L1960, L1970, L2005, L2036. Also included: E0748, osteogenesis stimulator, electrical, non-invasive, spinal applications.
The effective date for the news codes is April 2023.
The required...
Oxygen sign-on letter heads to CMS
August 11, 2022HME News Staff
WASHINGTON – Twenty two members of the House of Representatives have asked CMS to streamline documentation for home oxygen therapy, AAHomecare reports. A sign-on letter spearheaded by Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., requests that CMS: “Use the opportunity of expanding the current National Coverage Determination for oxygen to establish a clear set of criteria to support medical necessity and instruct the contractors to rely solely on the Standard Written Order...
Regulatory update: DME MACs notified, RACs limited
February 15, 2022HME News Staff
WASHINGTON – CMS on Feb. 10 published a change request notifying the DME Medicare Administrative Contractors of the agency’s new national coverage determination for home oxygen therapy.
CMS notes the following changes are effective for claims with dates of service starting Sept. 27, 2021:
expansion of oxygen coverage for acute and chronic conditions;
expansion of coverage for short and long-term need (when hypoxemia exhibited);
the ability of the MACs...