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Andrea Stark

Can CMS freeze SPAs without contracts?

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Monday, October 29, 2018
By Andrea Stark
reimbursement consultant, MiraVista, LLC

In the recent ESRD Proposed Rule, CMS conveyed their intent to freeze reimbursement in Competitive Bid Areas (CBAs) using the single payment amounts (SPAs) when the program ends on Dec.

Jurisdictions A and B: Phone demo is coming your way

Be on the lookout for correspondence from C2C Innovative Solutions, with demonstration in subject line
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10/26/2018

WASHINGTON – Christmas has come early for HME providers who have disputed Medicare claims.

Stark, Baird on post-Jan. 1

They address referral source re-education, capped rental conundrums, and outdated agreements
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09/14/2018

YARMOUTH, Maine – The Medicare landscape could look very different on Jan. 1, 2019, but industry watchers don’t expect any knee-jerk reactions from HME providers.

CMS upends oxygen CMN

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02/16/2018

WASHINGTON – CMS has changed the guidelines for reporting a patient’s oxygen flow rate on a CMN, a move that will have two serious implications for providers, particularly those servicing the critically ill, says Andrea Stark.

Settlement update: A non-option option for appeals

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12/08/2017

WASHINGTON – CMS has rolled out a new settlement option for low-volume appeals, but it’s not likely HME providers will take the agency up on its offer, stakeholders say.

Reporter’s notebook: Audit reprieve a ‘confidence builder’

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08/28/2017

MODESTO, Calif. – It’s not every day that HME providers get good news from a CMS audit contractor, but Home Oxygen Company recently got a break from certain audits.

Cures adjustments require planning

‘This is not a Publishers Clearing House prize, where they show up at the door and give you a cardboard check’
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06/30/2017

YARMOUTH, Maine – Sure, getting the money they’re owed will be great, but are HME providers ready to process adjusted claims?

Are you RAC ready?

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04/24/2017

Since it’s been so long since HME providers have had to grapple with a RAC, stakeholders offered these pieces of advice:

Providers prep for return of RAC

New contract, however, means several improvements to process
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11/18/2016

LIVERMORE, Calif. – Providers should strap in: After a protracted lull, RAC audits will likely pick back up in January, now that CMS has tapped Performant Recovery, based here, to perform post-payment reviews for DME and home health/hospice claims nationwide.

Create 'wiggle room' in profit margins

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09/23/2016

ATLANTA – Keeping an HME company in the black is a daunting proposition in the hardscrabble business environment of recent years, but four of Medtrade’s best instructors say it can be done despite the pitfalls providers constantly face.

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