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audits

RAC to audit test strips

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06/18/2019

WASHINGTON – Performant, the national RAC for DME, received approval from CMS on June 14 to audit blood glucose test strips (A4253) nationwide.

Home Oxygen Company earns another reprieve from audits

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05/10/2019

MODESTO, Calif. – Home Oxygen Company has earned another reprieve from audits for oxygen, due its success ratio of more than 90% in recent audits, the company says.

Advocate at every level

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02/22/2019

LAS VEGAS - Audits aren't going away, but providers who are proactive vs. reactive will see better results, says Juliet McBride, partner at King & Spalding LLP.

CMS tweaks TPE program

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01/08/2019

WASHINGTON – CMS on Dec. 31 implemented the “TPE 10-Claim Preview Pilot” to help reduce the burden for compliant DME providers, AAHomecare reports.

OIG to CMS: Collect Medicaid overpayments

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12/12/2018

WASHINGTON – CMS did not collect $1.6 billion in Medicaid overpayments in 77 current period audits and $188.6 million in seven prior period audits, according to a new report from the Office of Inspector General.

Stakeholders slam self-audits

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10/12/2018

WASHINGTON – A recent request by the DME MAC contractors for certain CPAP providers to audit themselves is setting them up to fail, say industry stakeholders.

van Halem: ‘Aggressive’ UPICs take over

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09/24/2018

ATLANTA – It’s time for HME providers to reacquaint themselves with the Unified Program Integrity Contractors, or UPICs, says Wayne van Halem.

Enteral nutrition, surgical dressings top error list

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05/15/2018

WASHINGTON – Enteral nutrition had the highest error rate (87%) from Targeted Probe and Educate audits in Jurisdiction D.

Judge getting impatient with HHS over massive ALJ backlog

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Friday, April 6, 2018
Elizabeth Hogue

I recently wrote an article entitled "Court Says No Recoupment Until After ALJ Hearings."  This article was about a court decision in which the judge said that recoupment of an extrapolated overpayment as a result of a ZPIC audit could not begin until after ALJ hearings were held.

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‘It is no longer worth the pit in my stomach’

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Wednesday, April 4, 2018

It’s always disappointing when the HME industry’s efforts to get relief from Medicare’s competitive bidding program fail to cross the finish line. But this last time around, when H.R. 4229 failed to make the cut in a recently passed omnibus bill, it was particularly disappointing.

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