Category Archives: Regulatory

UPDATE: National DMEPOS RAC on hold after protest filed by Connelly competitor

Earlier this year, CMS released information about the new national recovery audit contractor (RAC) that will take the place of the four regional RAC’s currently auditing DMEPOS claims. Prior to this release, CMS announced it had selected Connelly LLC, currently the … Continue reading

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New year brings new national RAC for DMEPOS

In 2014, CMS announced that Connelly LLC, currently a contracted auditor in Medicare Region C, was awarded the contract to become the first national recovery auditor for DMEPOS. The new national RAC will review claims throughout the entire country for … Continue reading

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CMS Announces New Phase of Controversial Competitive Bidding Program, OTS Orthotics Left Off

The Centers for Medicare and Medicaid Services (CMS) announced earlier this week that they will seek to hold a recompete of the bidding that set single payment amounts for Round 2 of Medicare’s Competitive Bidding program. Round 2 of the competitive … Continue reading

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Region D Scrutinizing K3 Feet

From time to time I like to present additional resources for OPGA members to review. The following post is from Ossur’s R&R blog and authored by David McGill, one of the leading audit experts in the O&P profession. The full post … Continue reading

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Medicare Contractors looking for O&P supplier violations on posted business hours and physical facility standards

BE ON THE LOOK OUT FOR SITE VISITS BY MEDICARE CONTRACTORS! Wanted to pass along this article to OPGA membership; recently OPGA was contacted by several members who have had site visits from CMS contractors looking to verify that the … Continue reading

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CMS begins rollout of fingerprint analysis for new DMEPOS providers

CMS recently released guidance on the rollout of their new fingerprint background check requirement for certain DMEPOS providers. It has been more than three years since CMS released their final rule on developing a fingerprint background check process for new DMEPOS and home health … Continue reading

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Results of Jurisdiction D Lower Limb Prostheses Prepayment Probe

More results from prepayment reviews of lower limb prostheses in Jurisdiction D DMEMAC Medical Review Department below. Based on the continued high error rate (79%)  on claims asociated with L5987, Noridian will close this prepayment probe and open a wide … Continue reading

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