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Rebasing Has Arrived – CMS Publishes Home Health PPS 2014 Proposed Rule

[07/02/13]

Posted on July 2, 2013 in Long-Term Care, Home Health & Hospice

Written by: Robert W. Markette

On June 27, 2013, CMS released the proposed home health prospective payment rule (the “PPS Rule”) for calendar year 2014.  While refinements to the ICD-9-CM and discussions of ICD-10-CM implementation are of interest, the most notable change to the PPS Rule for 2014 is CMS’s long-awaited proposal for rebasing home health payments.  Once it... READ MORE

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DMEPOS Round 2 Contract Suppliers Announced

[04/09/13]

Posted on April 9, 2013 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

The Centers for Medicare and Medicaid Services (“CMS”) announced today the contract suppliers for Round 2 and the national mail-order program of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”) Competitive Bidding Program. As of April 9, 2013, there are 799 suppliers that have been awarded contracts in this round, and these contracts will affect... READ MORE

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FDA Seeks Comments on Design of Medical Devices for Home Use

[03/01/13]

Posted on March 1, 2013 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

The Food and Drug Administration (“FDA”) is seeking comments on a draft guidance entitled “Design Considerations for Devices Intended for Home Use.”  The draft guidance urges manufacturers to “design out” product risks and consider usability and training for medical devices intended for use in a home environment.  The deadline for submitting comments on the... READ MORE

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HHS Announces First Settlement of HIPAA Breach Affecting Less Than 500 Individuals

[01/03/13]

Posted on January 3, 2013 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

On January 2, 2013, the Department of Health and Human Services (“HHS”) announced that it had reached a settlement with a hospice provider (“Hospice”) arising from potential violations of the Security Rule under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  HHS learned of the circumstances giving rise to the enforcement action... READ MORE

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Two Florida Home Health Agency Owners Plead Guilty to Fraud

[12/21/12]

Posted on December 21, 2012 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

On December 19, 2012 the Department of Justice announced the owners and operators of two Miami health care agencies pleaded guilty for their participation in a $48 million home health Medicare fraud scheme.  According to plea documents, the owners conspired with patient recruiters for the purpose of billing the Medicare program for unnecessary home... READ MORE

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Registration Open for DMEPOS Competitive Bidding Round 1 Recompete

[08/21/12]

Posted on August 21, 2012 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

Centers for Medicare & Medicaid Services (“CMS”) has announced that registration is now open to all suppliers interested in participating in the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program. In order to submit a bid for the Round 1 Recompete, suppliers will need to first... READ MORE

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Competitive Bidding Program Round 1 Recompete is Just Around the Corner

[07/12/12]

Posted on July 12, 2012 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program Round 1 Recompete will begin later this year.  Below is the schedule the Centers for Medicare & Medicaid Services (“CMS”) has announced so far:

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CMS Contractors to Review of Denials Relating to Face-to-Face Requirements for HHA Services

[12/09/11]

Posted on December 9, 2011 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

The Centers for Medicare & Medicaid Services (“CMS”) has recently instructed contractors to reopen certain claims that were previously denied for failure to meet the “face-to-face” requirements in certain circumstances and assuming all content requirements of the certification and the face-to-face documentation are otherwise met.  It came to CMS’ attention that certain claims were... READ MORE

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CMS Announces Timeline for Round 2 of Competitive Bidding

[12/01/11]

Posted on December 1, 2011 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

The Centers for Medicare & Medicaid Services (“CMS”) announced yesterday the timeline for Round 2 competitive bidding for Durable Medical Equipment, Prosthetics, Orthotics and Suppliers (“DMEPOS”), with registration set to begin on December 5, 2011. According to the release from CMS, the 60-day bid window for Round 2 and the National Mail-Order Competition for Diabetic... READ MORE

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Update to Scope of DMEPOS Claims Editing for Referring/Ordering Provider

[11/11/11]

Posted on November 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

Change Request (CR) 6421 was recently revised to remove chiropractors from the list of providers who may order or refer for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).  All other information in the CR remained the same.  As you will recall, in CR 6421, the Centers for Medicare & Medicaid Services (CMS) started the expansion of claim editing to... READ MORE

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