Audits


Editor's Note

If Not Now, When?

The time for hesitation is past. Providers must act on behalf of H.R. 5083 and H.R. 4920 if they want to fix audits, competitive bidding.

August Advocacy Boosts Industry Bills

Binding bids bill picks up 8 co-sponsors; audit reform bill adds 7 backers.

GAO Investigation: CMS Provided Insufficient Audit Oversight

Agency created a situation that quickly spiraled out of control; industry pushes AIR Act.

Audit Bill in the Works

Legislation would limit documentation look back periods; require timely filing limits; create education program.

VGM Acquires van Halem Group

Audit consulting firm will retain staff and offices to serve both VGM members and non-member DME, healthcare companies.

AAHomcare Announces ‘Massive’ Audit Program

Audit Key effort will collect data that completely, accurately tracks impact of Medicare audits.

HME Documentation Policies

The 2014 HME Handbook: Documentation

How to Protect Your Business with Iron-Clad Documentation Policies

Inaccurate Claim Denials Overturned

VGM effort to collect inappropriate denials for OMHA meeting pays off for providers.

Documentation: Dealing With Audits

While providers fight audits on the legislative front, they need to have a plan for dealing with them.

Breaking Through Audits

Business Solutions

Breaking Through Audits

CMS's audit onslaught has been a trial and tribulation for the HME industry, but matters took a turn for the terrifying when the agency announced that it would delay assigning Administrative Law Judges to audit appeals by two years. Now the industry has redoubled its efforts to bring an out-of-control situation back under control.



AAHomecare Outlines Audit Reform Objectives

Association advises Senate Finance Committee, gearing up to launch legislation, other initiatives.

HHS, DOJ Recover $4.3B in Fraud

Latest report details various instances of Medicare fraud, but doesn’t focus on DME as the central cause.

Industry to OMHA: Audit Process Is Broken

AAHomecare’s Ryan tells OMHA’s Griswold that ALJ delay has put providers in ‘crisis mode’ and a fix is needed fast.

Video: HMEs Comment on OMHA Meeting

VGM members share their thoughts on Appellant Forum proceedings, two-year ALJ delay.

Observation Deck

Flirting with Disaster

OMHA’s decision to delay assigning ALJs to audit appeals for up to more than 24 months does far more damage than holding recouped reimbursement in limbo. Even a cursory investigation of the latest developments make it patently clear that these delays may put more Medicare providers out of business than any other issue facing healthcare companies today.

CMS Lowers Interest Rates

Agency trims 0.5% off Medicare overpayments and sets underpayments to 10.125%.

NHIC Describes CERT Errors on Wheelchair Claims

Sample claims are said to be representative of the most commonly seen mistakes.

HME Competitive Bidding Thrill Ride

Business Solutions

The HME Thrill Ride

HME providers have been on a roller coaster over the past few years. What's in store for them from a regulatory and business standpoint in 2014, and how should they shape their business strategies to survive and succeed?

Provider Strategy

Broadening Your Product Range

With audits and decreasing reimbursement levels diverting your attention, it can seem more and more difficult to keep the focus on providing the best in patient care, but there are things you can do and products you can add to your “fleet” that will improve your business while enhancing patient care.

The van Halem Group Adds Senior Consultant

Kelly Grahovac joins audit, compliance consulting firm after a decade with Medicare contractor.

HME Business Podcast