Funding


Wayne van Halem

Provider Strategy

A Scary New Trend: Six-Year Lookback Audits

Understanding another 'new normal' for HMEs from HHS OIG.

CMS Slates Prior Authorization Call

July 11 conference call will address the prior authorization process for pressure reducing support surfaces.

CMS Adds More Round 2021 Webinars

Two webcasts for June will offer a two-part discussion of registering and submitting bids in Round 2021.

Home Oxygen Company Earns Audit Reprieve

California respiratory and sleep provider notches its fourth 12-month break from TPE audits.

Providers Prep for Round 2021 Bidding Summit

Attendees to June 5 Competitive Bidding Summit to learn more about Round 2021 and how to bid under lead item pricing.

Industry Hits Capitol Hill with Full Agenda

AAHomecare facilitates in-person meetings between lawmakers and industry advocates in Washington, D.C.; coordinates virtual fly-in for providers to remotely assist lobbying push.

Bidding, Oxygen Reform Bill Hits House

New legislation would provide permanent rural and non-bid area relief and eliminate the oxygen budget neutrality requirement.

UHC: No Change in Sleep Reimbursement Policies

A CPAP code was incorrectly added to an earlier policy update; AAHomecare seeking clarification on reprocessing any denied claims.

CMS Call to Cover Prior Auth., Round 2021

May 15 Open Door Forum will address CMS’s addition of 12 more items to prior authorization, as well as the next round of completive bidding.

Operation Brace Yourself Notches First Sentencing

Georgia DME CEO sentenced to more than three years plus fines and restitution for involvement in history-making Medicare fraud.



CMS Unveils Round 2021 Timeline

Registration starts June 10 and the bid window opens on July 16 for the next iteration of the competitive bidding program, which includes significant changes such as lead item pricing and bid surety bonds.

CMS to Host Round 2021 Webinars

CMS series of three webinars will cover various topics related to Round 2021 during May.

CMS Solidifies Dates for Expanded Prior Authorization

Prior authorization for most new codes added to the program goes into effect on July 21, with PA for the remainder to going into effect on Oct. 21.

Round 2021: Do You Understand Lead Item Pricing?

CBIC, AAHomecare, industry experts all emphasize the need for providers to start using lead item pricing calculators and educate themselves on the pricing method well before Round 2021 bidding begins.

Oklahoma Poised to Exempt HME from Sales Tax

Ongoing advocacy work by OMEPA results in both chambers approving H.B. 1262, which would free HME items from the Sooner State’s sizable sales tax; Governor poised to approve.

Industry Reacts to Massive Medicare Fraud Bust

In one of the biggest healthcare frauds in U.S. history, the Feds round up DMEs, telemarketers and medical professionals in a $1.2 billion orthopedic brace scam; various industry insiders share their perspective.

Industry Advocates Launch Round 2021 Education Site

The new site, dmecbpeducation.com, offers a variety of resources to help providers prepare for Round 2021, including bid calculators based on new lead item pricing system.

Observation Deck

Understanding Managed Care

What are Managed Care Plans and how can HME providers properly prepare to negotiate agreements with those plans?

CBIC Alerts Commonly Owned, Commonly Controlled Providers

Bid contractor urges providers to review their enrollment records now, and ensure they understand the commonly owned and commonly controlled distinctions.

VGM Insurance Offers Bid Bonds

VGM Insurance Services partners with Lexon Insurance Company to help HME providers meet new surety bond requirements for Round 2021.

HME Business Podcast