CMS Easing DME MAC Requirements

The Centers for Medicare and Medicaid (CMS) is modifying requirements for DME Medicare Administrative Contractors (MACs) by allowing them to accept timely orders and medical documentation, regardless of whether the supplier received the documentation directly from the beneficiary’s eligible practitioner or from a transferring supplier, as long as they meet Medicare requirements. In a Change […]

Finalized DME rule targets fraud, abuse

The Centers for Medicare and Medicaid Services has finalized a rule that creates a prior authorization process for some durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that it has determined are often subject to unnecessary utilization – i.e. healthcare fraud. The rule was first proposed in May 2014 and included a Master List of […]

OIG adds 21 new investigative focus areas

The Office of Inspector General at the U.S. Department of Health and Human Services recently released the midyear update  of its annual work plan, which not only outlined its accomplishments between October 2014 and May 2015 but also added 21 new focus areas for next year. The OIG noted that it will continue to look […]

Next phase in Medicare DMEPOS competitive bidding announced

The Centers for Medicare & Medicaid Services (CMS) has announced the new bidding timeline for Round 2 recompete and the national mail-order recompete of the Medicare Durable Medical Equipment, (DME) Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program. The 63-day window opens on Jan. 22, 2015 and runs through March 25, 2015. On Nov. 6, […]

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