The settlement involved claims that hinged on a set of Medicaid billing regulations that the company believed it had interpreted correctly.
- By David Kopf
- Feb 09, 2023
The DOJ reports that 2022’s False Claims Acts settlements included claims for DME, drugs, home health, managed care, hospitals and physicians.
- By David Kopf
- Feb 09, 2023
Those involved acquired patient referrals and signed doctors’ orders by paying kickbacks to marketers who used overseas call centers to solicit Medicare beneficiaries for unneeded DME.
- By David Kopf
- Feb 09, 2023
In the first guidance on how it will handle audits after the Covid-19 public health emergency, CMS offers clarifications on dates of service and the nature of the audits.
- By David Kopf
- Nov 10, 2022
Observation Deck
- By Wayne van Halem
- Jun 01, 2022
Requests for additional documentation will be based on the number of claims a provider has in a category.
Business Solutions
Once again, we proofile 10 trends that will shape the HME industry this year. The far-reaching impact of Covid-19 is undeniable, but it’s not the only factor that will define 2022.
- By David Kopf
- Feb 01, 2022
Problem Solvers
Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect for this year.
- By David Kopf
- Feb 01, 2022
Podcast
Providers will see an increase in claims audits from Medicare and other funding sources in 2022. Audit expert Wayne van Halem offers insights into what they can expect.
- By David Kopf
- Jan 19, 2022
Both audit program contractors have announced new audits for surgical dressings, enteral nutrition, and parenteral nutrition.
Observation Deck
With the COVID-19 audit pause well behind us, multiple indicators show CMS is quickly resuming audits in a big way. What do HME providers need to know?
- By Kelly Grahovac
- Sep 09, 2021
Observation Deck
- By Kelly Grahovac
- Aug 01, 2021
MACs may now conduct post-payment medical reviews of items and services with dates of service after March 2020.
- By David Kopf
- Jun 03, 2021
Several months ago CMS threatened it would resume its claims audits. Now that is happening and audit expert Wayne van Halem provides the details on what’s happening and what providers need to know.
- By David Kopf
- Apr 07, 2021
Top-line audit concern includes HHS OIG adding PAP supplies to Its workplan. Wayne van Halem will discuss several new, worrying audit developments and how to prepare for them in Dec. 11 webinar.
- By David Kopf
- Nov 26, 2019
Podcast
Sleep equipment providers risk facing costly six-year lookback audits in this new addition to OIG's workplan. How should they prepare?
- By David Kopf
- Oct 17, 2019
The medical device manufacturer says the certification will allow for more growth in the market and improved efficiency.
- By Haley Samsel
- Oct 14, 2019
Business Solutions
CMS's six-year lookback audits represent a daunting challenge for HME providers, but there are steps they can take to deal with them.
- By Holly J. Wagner
- Oct 01, 2019
Performant will only review HCPCS code A4253 and claims paid date must be within three years before the Additional Documentation Request.
- By David Kopf
- Jun 20, 2019
Provider Strategy
Understanding another 'new normal' for HMEs from HHS OIG.
- By Wayne van Halem
- Jun 01, 2019