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CMS Proposes Changes to the Oxygen NCD

CMS has published proposed changes to the Oxygen National Coverage Determination (NCD). If approved, these changes would be considered a “win”...

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CMS Proposes Changes to the Oxygen NCD

CMS has published proposed changes to the Oxygen National Coverage Determination (NCD). If approved, these changes would be considered a “win” for the industry and, more importantly, expand access for beneficiaries. The public has 30 days...

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FDA releases safety information related to the Philips recall

On June 30, 2021, the U.S. Food and Drug Administration (FDA) published a safety communication to their website. The FDA communication urges patients using the affected devices to talk to their health care providers to determine a suitable treatment...

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Noridian Frequently Asked Questions - Philips Respironics Respiratory Products Recall

On June 14, 2021, Philips Respironics announced the voluntary, global recall of an estimated 4 million continuous positive airway pressure (CPAP) devices, bilevel respiratory assist devices (RADs), and ventilators. The situation is quite fluid; consequently,...

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Live Discussion: Impact of the Philips PAP Recall on Patient Care

Impact of the Philips PAP Recall on Patient Care and Sleep Center Operations Today, Friday June 18, at 3:00-4:00pm (ET) the American Academy of Sleep Medicine is hosting a live panel discussion with representatives from the American Academy of...

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Updates to Glucose Monitor LCD and Policy Article

The FUTURE Local Coverage Article: Glucose Monitor - Policy Article (A52464) and FUTURE Local Coverage Determination (LCD): Glucose Monitors (L33822) are now available for viewing on the CMS website. While most of the edits are minor changes to verbiage,...

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DMEPOS Suppliers see spike in commercial audits

Last week CMS announced that MACs would expand their postpayment audit scope to include dates of service after March 1, 2020. Previously, MACs had been restricted to auditing pre-pandemic claims only.  In addtion to increased audit activity...

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Provide Custom Fabricated or Prefabricated (Custom Fitted) Orthotics? You may need to update your enrollment file!

CMS issued CR 12282 to communicate the addition of HCPCS codes that require the use of a licensed/certified orthotist or prosthetist for furnishing custom fabricated and prefabricated (custom fitted) orthoses.  This change will apply...

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MACs Resume Medical Review on a Post-payment Basis

Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The...

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Bid winners in the off-the-shelf bracing category should be wary of lead-generation services

By Wayne van Halem, President, The van Halem Group Direct-to-consumer marketing and lead-generation are perfectly legal manners in which to court potential customers. However, with Medicare patients, there are a number of laws that HME suppliers...

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CMS new demonstration project to include Nurse Practitioners as Certifying Physicians for Therapeutic Shoes and Inserts

Effective January 1, 2021 and extending through December 31, 2025, CMS is exercising its authority to allow nurse practitioners to certify that an order for diabetic shoes is required under a new model demonstration for certain states. Under this...

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