Funding


Editor's Note

Enough Is Enough

Two years have demonstrated that the madness of audits needs to stop.

Senators Seek Anti-Fraud Solutions from Healthcare Community

Open letter calls on professionals to provide 'fresh perspective' on identifying, fighting 'waste, fraud and abuse.'

Observation Deck

The Time for Compliance Is Now

The reality is that the Affordable Care Act has made it mandatory for all healthcare providers, at some point, to implement a comprehensive compliance program that meets or exceeds government expectations. Why not make the investment of the front end to better prepare your organization, implement effective internal controls, improve the efficiency of your staff, and provide better quality of service to your patients?

CMS Explores PMD Physician Evaluation Template

Templates could become important element in CMS's pre-payment review demo project.

CMS Slates Two Open Door Forums

March 21 call will discuss mobility authorization demo; April 11 call currently sans agenda.

CMS Releases Rule on Solicitation, Subcontracting

Effective April 13, final rule prohibits providers from directly contacting beneficiaries via phone without 'written' consent.

CMS Proposes 10-Year Claims Review

Proposed rule would implement aggressive enforcement of Affordable Care Act provision that could pose problematic to providers.

Observation Deck

Pre-Payment Problem Solving

While CMS gave the impression the project was limited in scope, since it only encompassed seven states, the reality is it included 43 percent of the power mobility marketplace. What should PMD providers be doing?

CMS Call Outlines Demonstration Project Details

Today’s Open Door Forum yields PMD prior authorization project dates.

Software System Audit Features



Word to the Wise: the KX Modifier

Surviving the Audit Tidal Wave

Products & Technology

Surviving the Audit Tidal Wave

Since the start of 2011, providers have been fending off a relentless onslaught of pre- and post-payment audits on Medicare claims. How can technology help them win this war of attrition?

PAMS Launches Compliance Education

Sponsored by various state organizations, the series is open to members and non-members.

U.S. Health Spending Rates Hit Historic Lows

CMS report shows 2009-2010 spending grew by only 3.9 percent.

Private Payor Insurance

The Big 10

Private Payor

There is no doubt that private payor funding will see change in 2012 and perhaps even bigger change during the next.

Audits

The Big 10

Audits

Audits were the biggest issue immediately threatening the industry through 2011, and while the industry deals with the bidding of Round Two of competitive bidding, and works to advance the marketing pricing program as an alternative, audits will remain a serious issue for 2012.

Dream, VGM Partner for Audit Solution

VGM offers members discounts of HME prescription, documentation system that safeguards against audits.

Industry, Patients: ‘Stop Mobility Pre-payment Review — Now'

Provider and consumer advocates call on Congress to cease implementation of power wheelchair program.

Anthem Rescinds Termination Policy

Providers in the network do not need to overhaul their DMEPOS accreditation.

HHS OIG: ZPICs Hindering Oversight

Report says Anti-Fraud Contractors used bad data to report workloads while being paid $22+ Billion.

HME Business Podcast