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MCOs shift Medicaid landscape

‘We are disappointed that they are taking away quality customer service and care’
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08/18/2017

YARMOUTH, Maine – Managed care organizations targeting single-source or preferred provider contracts to provide DME and supplies for Medicaid recipients is a trend that’s spreading across the country, according to the results of a recent HME Newspoll.

Regulatory news: CMS revamps audits, lawmakers question CPAP bundling

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08/18/2017

WASHINGTON – Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.

In brief: HHS scores win in appeals fight, Superior HealthPlan makes changes to Medline contract

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08/18/2017

NEW YORK – The D.C. Circuit on Aug. 11 ordered a federal judge to take a deeper look at whether or not the U.S. Department of Health and Human Services can clear a backlog of about 600,000 appeals by 2021, while still protecting taxpayer dollars, according to Law360.

CMS revamps claims review process

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08/16/2017

WASHINGTON – Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.

Superior HealthPlan to make changes to Medline contract

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08/15/2017

AUSTIN, Texas – Superior HealthPlan, a managed care company that’s administering part of the state’s Medicaid program, has decided to delay a contract with Medline until Oct. 1, according to the San Antonio Express-News.

In brief: Apria settles with MassHealth, Trump stalls sleep reg

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08/11/2017

LAKE FOREST, Calif. – Apria Healthcare has agreed to pay more than $750,000 to settle allegations that it billed Massachusetts residents for services already covered by MassHealth, the state’s Medicaid program.

In brief: NSM makes big play in Michigan, Health Complex rebrands

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08/04/2017

NASHVILLE, Tenn. – National Seating & Mobility has acquired the mobility division of Wright & Filippis, positioning the company as the leading provider of complex rehab solutions in Michigan, it says.

Stakeholders grease wheels for possible action in September

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07/28/2017

WASHINGTON – Industry stakeholders have legislative language being vetted that would freeze payment rates at the Jan. 1, 2016, amounts, and fix the so-called “double-dip” for oxygen payments.

AAH launches survey to dig deeper into access issues

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07/28/2017

WASHINGTON – Industry stakeholders are reaching past the ranks of HME providers to gauge the impact of competitive bidding, as they continue to push for reforms to the program.

In brief: Temporary payment for home infusion passes House, Stratice partners with athenahealth

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07/28/2017

WASHINGTON – A bill that reforms several Medicare benefits, including home infusion and O&P, sailed through the House of Representatives last week.

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