Tag Archives: DMEPOS

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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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

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CMS to Create New National RAC for DMEPOS, Home Health

CMS recently announced their intent to create a fifth Recovery Audit Contractor (RAC), in addition to the four current regional RAC’s. This new national contract would be awarded specifically for identifying improper payments for home health, hospice claims and payments for … Continue reading

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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

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Widespread Review of Spinal Orthoses Brings 90% Denial on L0631 and L0637 Claims

Jurisdiction D DME MAC recently completed a widespread prepayment review of certain spinal orthoses, L0631 and L0637, due to an analysis compiled by CERT audit contractors.  The results are very troubling and will likely trigger more widespread reviews of the L codes … Continue reading

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Round 2 DMEPOS Competitive Bidding Categories Released, O&P Not Included

The Centers for Medicare and Medicaid Services (CMS) released their preliminary list of product categories that will be part of Round 2  Durable Medical Equipment, Prosthetics, Orthotics Supplies (DMEPOS) Competitive Bidding Program beginning in the summer of 2013.  Round 1 … Continue reading

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