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Author Archives: ryanball1
Obamacare Update: State Health Exchanges, Medicaid See Enrollment Surge
As the calendar turns to 2014 and the Affordable Care Act (aka, Obamacare) continues moving its way through implementation, now is a good time to provide an update on the much-maligned state health exchange rollout and Medicaid expansion enrollment data to get … Continue reading
Posted in Orthotics and Prosthetics, Patient, re provider
Tagged medicaid, obamacare, opga, orthotics, point, prosthetics
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PECOS Phase II Active for Claims Beginning January 6, 2014
Phase 2 of the controversial Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) program becomes active for claims submitted to Medicare beginning Monday, creating more headaches for those filing orthotic and prosthetic claims for Medicare patients. After delaying Phase 2 … Continue reading
Posted in Orthotics and Prosthetics, Patient, Prosthetist, re provider
Tagged medicare, opga, orthotics, pecos, phase ii, prosthetics
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CMS Begins Rollout of Fingerprint Background Checks for DMEPOS Suppliers
According to recently released documents, early in 2014, CMS plans to award a contract to perform fingerprint analysis and background checks for certain Medicare providers and suppliers. It has been nearly three years since CMS released their final rule on developing … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider, Regulatory
Tagged CMS, finger print, opga, orthotics and prosthetics
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2014 DMEPOS Fee Schedule Released
With all of the different regulatory challenges and movements by payers to drive down reimbursements, even the slightest bit of good news can be reassuring. To that end, the 2014 Medicare DMEPOS fee schedule was released earlier this week and … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged DMEPOS, fee schedule, opga, orthotics, prosthetics
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CMS Releases Dear Physician Letter on PECOS Phase II
Last month, CMS again announced that Phase II of their troubled PECOS program would be activated beginning on January 6, 2014. Earlier this week, CMS finally got around to releasing updated guidance to physicians informing them of the requirements they must … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged CMS, opga, orthotics, pecos, prosthetics
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Budget Deal Leaves in Place 2% Cut to Medicare Providers
Negotiators from the House and Senate announced a budget deal late last night to stave off nearly $100 billion in new budget cuts set to become active on January 1, 2014 without new legislation. The compromise bill, negotiated by Budget … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged opga, orthotics, prosthetics, sgr
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Bowling for Denials
I wanted to pass along a very interesting post from Ossur’s R&R blog by David McGill on Medicare contract auditors trolling for information in an attempt to rewrite requirements for lower limb prostheses to their liking. If you are not … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged audits, opga, orthotics and prosthetics, ossur
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ACA Health Exchange Enrollment Down, Medicaid Enrollment Up
Under fire since October 1st, the Obama Administration has finally announced the figures from the first month of the enrollment period for Americans to obtain health insurance in advance of the individual mandate becoming active in 2014. Under the mandate, … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist
Tagged medicaid, opga, orthotics and prosthetics, state exchange
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PECOS Phase II Back Again, Implementation January 6, 2014
As if dealing with documentation requirements and independent bounty hunters masquerading as auditors were not enough, CMS again recently announced that they will move forward with Phase 2 of the Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) program, creating … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged opga, orthotics, pecos, prosthetics
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Deal Reached to Fund Government, Raise Debt Ceiling
Leaders in the United States Senate yesterday unveiled a bipartisan plan to end the two-week long shutdown of th Federal government and raise the nations’ borrowing authority to avoid a default. The Continuing Appropriations Act extends current sequester level funding for the … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged budget, opga, orthotics and prosthetics, rac audits, shutdown
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