Tag Archives: medicare

CMS to Temporarily Halt RAC Audits to Transition to New Contracts

After receiving pressure from more than 111 individual members of congress about the over aggressive nature of CMS’ RAC audit program, CMS announced earlier this week that they will temporarily halt new RAC audit requests to allow existing contracts with … Continue reading

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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

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OPGA to Attend Medicare Audits Hearings & Appeals Forum, Seeks Stories

The recent memorandum sent to Medicare appellant from Chief Administrative Law Judge Nancy Griswold detailing the incredible appeals backlog, and subsequent decision to suspend assigning dates for new ALJ hearings for the next 24 months, has created a fervor of … Continue reading

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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

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Sign Petition, Tell Medicare to Stop

I wanted to pass along a link to an organic petition started by independent prosthetist Jeff Erenstone that has gained considerable attention over the past week. Jeff started an online petition to hold medicare responsible for not requiring that they … Continue reading

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Sequestration Brings 2% Cuts to O&P Claims Beginning April 1, 2013

We’ve all read about the dreaded sequestration cuts; the direct impact on orthotic and prosthetic providers will be a 2% across the board cut to Medicare reimbursements beginning with claims filed on or after April 1st.  Medicaid is exempt from … Continue reading

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Oversight of Medicare Audit Contractors, Surety Bond Comments

Lost in the media attention surrounding the Supreme Court ruling on the Affordable Care Act was the fact that key members of both parties, including: Senators Hatch, Baucus, Coburn, Carper, Grassley and Congressmen Waxman, Stearns, Boustany, Lewis and DeGette, recently sent a letter … Continue reading

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