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NewsPoll: Providers receive some far-out denials


YARMOUTH, Maine – Imagine having a claim denied because Medicare doesn’t like the handwriting on the prescription.

A good news week

Friday, January 9, 2015

I blogged last week about how the industry saw some good progress, but no resolutions, on its top issues of competitive bidding and audits in 2014.

Well, it’s off to a good start in 2015.

Groups set stage for action on audits


WASHINGTON – Even though the American Hospital Association (AHA) lost its bid to get a court to intervene in a huge backlog of appeals of Medicare claims, the lawsuit keeps the controversial program in the spotlight, industry stakeholders say.

Rip Van Winkle? Not so much

Tuesday, December 30, 2014

You’d think, after taking a three-month maternity leave, that I’d I feel a little bit more Rip Van Winkle about the HME industry.

DME MAC launches manual wheelchair review


INDIANAPOLIS – So far, few providers in Jurisdiction B seem to be affected by a recent prepayment review for manual wheelchair bases, including adult tilt-in-space models (E1161).

Expect more aggressive audits


ATLANTA – Medicare has gone from pay-and-chase to not letting the money out, says healthcare attorney Denise Leard.

The result is more—and meaner—audits, she said during a session at Medtrade in October.

Appeals backlog soars, solutions don’t appear imminent


WASHINGTON – Less than a year after a massive appeals backlog at the Administrative Law Judge (ALJ) level first came to light, that backlog has nearly tripled.

Bills get bump from fly-in


WASHINGTON – A legislative fly-in on Sept. 10 spearheaded by The MED Group and supported by AAHomecare resulted in 100 meetings with lawmakers.

Providers on denied claims: ‘We’ll fight to the end’


YARMOUTH, Maine – A defiant 60% of the respondents to last week’s HME NewsPoll say they wouldn’t take up CMS on an offer to settle pending appeals in exchange for partial payment.

In brief: CMS responds to AAH, complex rehab bill adds sponsors


WASHINGTON – Contractors conducting pre-pay audits and prior authorizations are required to load that information into the RAC Data Warehouse, CMS has said in response to an AAHomecare inquiry.