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audits

QIC will transition from C2C to Maximus

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06/28/2019

WASHINGTON – C2C Innovative Solutions has lost its bid to remain CMS’s Qualified Independent Contractor for HME, according to AAHomecare.

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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