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audits

Hot in the Heartland

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Wednesday, June 14, 2017

There’s an old saying: If you can’t take the heat, get out of the kitchen.

Senate committee prioritizes audit, appeals reform

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05/26/2017

WASHINGTON – Forcing Medicare to better coordinate audits and improve the appeals process is one of the top priorities of the Senate Finance Committee this year, Kimberly Brandt told attendees at the AAHomecare Washington Legislative Conference on Wednesday.

Appeals backlog wears on

‘Hopefully we’re still in business when our cases get to a judge,’ says provider Donna Barraclough
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05/19/2017

YARMOUTH, Maine – A whopping 92% of respondents to a recent HME Newspoll say they have claims stuck at the administrative law judge level and are waiting—and waiting—for hearing dates.

Rep. Blackburn introduces prior auth legislation

Stakeholders applaud the move, believe CMS isn’t moving fast enough to require PA for broader spectrum of HME
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05/17/2017

WASHINGTON – Rep. Marsha Blackburn, R-Tenn., has introduced legislation that would require prior authorization for certain high priced HME, AAHomecare reported this morning.

Performant ready to roll

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03/10/2017

LIVERMORE, Calif.

New RAC posts new reviews

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02/24/2017

WASHINGTON – Performant Recovery, the new national recovery audit contractor (RAC) for DMEPOS and home health/hospice, has posted seven new reviews on its workload page, according to AAHomecare.

Expect audits to get more aggressive

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01/27/2017

atlanta – When ZPIC auditors come calling, it’s important not to throw up your hands in surrender because there’s too much at stake, said healthcare attorney Ross Burris.

CMS contractor expands phone demo

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11/04/2016

JACKSONVILLE, Fla. – C2C Innovative Solutions, the contractor handling the second level of the Medicare appeals process, has received the green light from CMS to expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.

New RACs and new rules

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Wednesday, November 2, 2016
Elizabeth Hogue
attorney

CMS has selected five new recovery audit contractors (RACs) and established new rules. RAC audits will undoubtedly resume soon. Performant and Cotiviti were awarded contracts, along with HMS Federal Solutions.

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CMS taps Performant for nat’l RAC for DME

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11/02/2016

WASHINGTON – CMS has tapped Performant Recovery to perform post-payment reviews of Medicare claims for DMEPOS and home health/hospice nationwide.

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