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More MA audits on the way?


WASHINGTON – CMS is considering expanding its RAC program for Medicare Advantage, according to a draft scope of work published by the agency.

CMS provides update on RACs


BALTIMORE – CMS has released requests for proposals for the next round of the recovery auditor contracts.

Shift your mindset about audits


ATLANTA – Audits strike fear in the hearts of many providers.

CMS limits scope of audits


WASHINGTON – For redeterminations and reconsiderations of claims denied following a post-payment review or audit, CMS has instructed the MACs and QICs to limit their scope to the reason the claim or line item was initially denied, according to a recent MLN Matters article.

HME is getting more…well, sophisticated

Tuesday, August 25, 2015

I was reading a study titled “Retrospective Assessment of Home Ventilation to Reduce Rehospitalization in Chronic Obstructive Pulmonary Disease” in the Journal of Clinical Sleep Medicine when I

GAO finds fragmented oversight of Medicaid


WASHINGTON – CMS needs to do a better job overseeing Medicaid managed care, the Government Accountability Office says in a report public released June 18.

AAH softens blow of Medicaid cuts


WASHINGTON – AAHomecare has successfully lobbied the House Energy and Commerce Committee to delay the start date for a provision reducing Medicaid payments to 2020 instead of 2016.

Blackburn’s bill seeks to expand prior authorizations


WASHINGTON – Rep. Marsha Blackburn, R-Tenn., introduced a bill last week that would require prior authorizations for high-dollar DME.

PFQC launches ‘Faces Behind the Red Tape’


WATERLOO, Iowa – People for Quality Care has launched a new online series called “Faces Behind the Red Tape” to document the impact of audits on Medicare beneficiaries.

GAO clears way for Connolly


WASHINGTON – CMS will likely move forward with Connolly as its contractor for the new national RAC for DMEPOS, home health and hospice, according to industry consultant Andrea Stark.