-
Recent Posts
- UPDATE: National DMEPOS RAC on hold after protest filed by Connelly competitor
- New year brings new national RAC for DMEPOS
- CMS elects to wait on implementation of ‘minimal self-adjustment’ and ‘specialized training’
- AOPA backed audit lawsuit dismissed by District Court
- CMS Informs Congress of intention to re-start portions of RAC program
Categories
Archives
- January 2015
- November 2014
- August 2014
- July 2014
- June 2014
- May 2014
- April 2014
- March 2014
- February 2014
- January 2014
- December 2013
- November 2013
- October 2013
- August 2013
- July 2013
- June 2013
- May 2013
- April 2013
- March 2013
- February 2013
- January 2013
- December 2012
- November 2012
- October 2012
- August 2012
- July 2012
- June 2012
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- May 2010
Blogroll
Twitter Updates
- RT @NAAOandP: The O&P Patient Centered Care Act (H.R. 5262) has been introduced in the House of Representatives. Contact your members of Co… 19 hours ago
- RT @VGMGovRelations: Our Government team travels far and wide for our members! Just this year, our team traveled the equivalent of 143 time… 1 day ago
- Wishing you a happy Thanksgiving! https://t.co/ACNM3fgCjF 6 days ago
Tag Archives: audit
AOPA backed audit lawsuit dismissed by District Court
The United States District Court of the District of Columbia recently dismissed a case brought by the American Orthotic and Prosthetic Association (AOPA) against Former Secretary of the Department of Health and Human Services Kathleen Sebellius. The suit focused on the authority of … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged AOPA, audit, CMS, opga, orthotics, prosthetics, RAC
Leave a comment
CMS Informs Congress of intention to re-start portions of RAC program
From HealthDataManagement.com : The Centers for Medicare and Medicaid Services is restarting the controversial Recovery Audit Contractor Program—in a limited fashion—in August. CMS sent a communication on August 4 to congressional health staff members from Lauren Aronson, Director of the … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged audit, CMS, o&p, opga, orthotics, prosthetics, RAC
Leave a comment
ALJ Forum Light on Relief, Stakeholders Voice Frustrations
The Office of Medicare Hearings and Appeals held a forum today in Washington DC on the recently disclosed 460k Administrative Law Judge (ALJ) appealed claims backlog. Chief ALJ Nancy Griswold headlined a day long event which featured updates from OMHA … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged alj, audit, medicare, omha, opga, orthotics, prosthetics
1 Comment
How to stop CMS from taking your $$
I wanted to pass along this great post from Linda Collins and the Ossur Regulatory blog. Linda describes how an independent O&P can stop CMS from withholding/requesting overpayments until much later in the appeals process by being organized and replying … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged audit, CMS, opga, orthotics and prosthetics, ossur, RAC
Leave a comment
CERT Prepayment Review on High Cost Claims Shows 89% Denial Rate
NGS in Jurisdiction B recently completed an analysis of prepayment review claims focused on medical necessity in the third quarter of 2012. The claims selected were based on a selection of high dollar claims and targeted services from multiple suppliers. The review included claims for orthotics … Continue reading
Posted in Orthotics and Prosthetics, Prosthetist, re provider
Tagged audit, CERT, denial, medical necessity, opga, orthotics and prosthetics
Leave a comment
OIG: ALJ’s Overturn 56% of Provider Generated Appeals to QIC Audits
The HHS Office of Inspector General earlier this month released a report which studied the shockingly high overturn rate of provider generated appeals to private contract auditors employed by CMS to the Administrative Law Judge level. The OIG found that 56% … Continue reading
Posted in Manufacturer, Orthotics and Prosthetics, Prosthetist, re provider, Regulatory
Tagged alj, audit, hhs, OIG, opga, orthotics and prosthetics, qic, RAC
Leave a comment
HHS Releases Medicaid RAC Final Rule
The Department of Health and Human Services on Wednesday released a final rule implementing Section 6411 of the Patient Protection Affordable Care Act that calls for states to create and maintain a relationship with a “Recovery Audit Contractor” to identify improper payments and … Continue reading
Posted in Manufacturer, Orthotics and Prosthetics, Prosthetist, Regulatory
Tagged audit, medicaid, opga, orthotics, point, prosthetics, RAC
Leave a comment