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Monthly Archives: February 2013
IG Report: CMS Must Recoup Additional Medicaid Overpayments
Earlier this month CMS Office of Inspector General released a report highlighting CMS’s inability to adequately recoup over payments made to state Medicaid agencies, and by extension, Medicaid providers. The report identified $226 million in unclaimed overpayments in 11 states … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged medicaid, opga, orthotics and prosthetics, overpayments
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PDAC Revises Definitions for L1906, Removes Height Requirement
Seeking consistency with the DME MAC LCD Policy Article released on January 1, 2013, the Pricing Data Analysis and Coding contractor (PDAC) has revised definitions for L1906, removing a key height requirement that had caused significant issues for prosthetists. Below … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged l1906, opga, orthotics and prosthetics, pdac
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Jurisdiction D External Breast Prosthesis Prepayment Review Findings
Earlier this week Jurisdiction D DME MAC Medical Review Department announced their findings of a widespread prepayment review of L8030. This prepayment review probe was created after the review of a Comprehensive Error Rate Testing (CERT) analysis. Much like the findings … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged CERT, jurisdiction d, opga, orthotics and prosthetics
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Senate Finance Committee Releases Report Highlighting Audit Issues
Yesterday a bipartisan group of Senate Finance Committee members released a new report entitled “Opportunities to Curb Waste, Fraud and Abuse in Medicare and Medicaid.” Senators included Baucus (D-MT), Hatch (R-UT), Grassley (R-IA), Carper (D-DE), Wyden (D-OR) and Coburn (R-OK). … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged audits, DMEPOS, opga, orthotics and prosthetics, vgm
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