Tag: Cap
New law complicates non-assigned claims in Nebraska, possibly elsewhere
September 11, 2024Liz Beaulieu, Editor
LINCOLN, Neb. – HME providers in Nebraska must change how they handle Medicare non-assigned claims, after Mutual of Omaha, a supplemental insurer, and the Nebraska Insurance Federation successfully lobbied the state legislature to limit how much they charge over the allowed amount.
A new law that went into effect in July states that nonparticipating Medicare providers can’t “balance bill” a beneficiary in Nebraska for any DMEPOS unless the beneficiary (1) agrees in...
Capped rental: National companies brush by change
June 20, 2014Leah Hoenen
ROCKY HILL, Conn., and FRANKLIN, Tenn. - The capped rental rule will squeeze cash flow and generate more paperwork, national mobility providers say, but it's not altering their strategies just yet.
The rule, which went into effect in April, requires providers to send claims to Medicare and secondary payers each month of a 13-month rental period to receive full payment.
“There may be a time in the future where we have to assess what products we put out the door,” said Kevin Harmon,...
Reporter's notebook: Manufacturers hedge bets on capped-rental change
May 23, 2014Liz Beaulieu, Editor
YARMOUTH, Maine - What's the impact on manufacturers of the transition to capped-rental status for certain complex rehab items?
So far, they're hedging their bets.
The transition went into effect April 1, prompting some providers, such as Monroe Wheelchair, to discontinue providing items like power-assist devices.
But Exeter, Pa.-based Pride Mobility and Quantum Rehab report little impact from the change, mostly because it's “largely a manual and pediatric wheelchair issue,”...
Another potential Medicaid nightmare
May 24, 2010Liz Beaulieu, Editor
Gov. Arnold Schwarzenegger this month issued a revised state budget for 2010-11 that proposes capping spending for DME, even power wheelchairs, to about $1,800 per Medi-Cal recipient per year.
“Part of it is, they haven't been successful in cutting reimbursement rates, so they're getting desperate,” said Bob Achermann, executive director of the California Association of Medical Product Suppliers (CAMPS). “The other part of it is, the governor is telling the legislature, 'This is...