Home Blog

default blog image
Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization

By Kelly Grahovac, General Manager, The van Halem Group In recent months, the Office of Inspector General (OIG) has been working to update their compliance...

Read Full Post

Recent Blog Posts

9bdbcd2026c3659fa97ee27d4c209be7.png
Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization

By Kelly Grahovac, General Manager, The van Halem Group In recent months, the Office of Inspector General (OIG) has been working to update their compliance guidance. This was first apparent in the revisions made to corporate integrity agreements (CIAs)...

Read Full Post

Audit Alert: UPICs focus on CGM and supplies

The van Halem Group has identified an increase in UPIC audit requests for CGM and supplies for both pandemic and current dates of service. The UPICs are auditing providers on both a prepayment and postpayment basis. CMS recently indicated that they wanted...

Read Full Post

Changes to EFT authorization agreement form (CMS-588) submissions

Effective August 21, 2023, Electronic Funds Transfer (EFT) Authorization Agreement Form (CMS-588)  must be sent to the applicable National Provider Enrollment (NPE) contractor for the supplier’s physical location. Please refer to the below...

Read Full Post

RAC adds two new topics to CMS approved audits issues list

Performant, the national home health, hospice, and DMEPOS recovery audit contractor (RAC), added two new items to their CMS approved audit issues list. Both are identified as complex reviews, meaning providers that bill these services could be subject...

Read Full Post

DMEPOS Competitive Bidding Program on temporary hold

On Thursday, May 25, 2023, CMS announced that the DMEPOS Competitive Bidding Program will begin a temporary gap period, starting January 1, 2024. In the weekly Medicare Learning Network (MLN) MLNConnects newsletter, CMS provided details on the current...

Read Full Post

Audit Forecast: Recent Publications and Activities Hint at Audit Increases Across Multiple Payers

By Wayne van Halem, President, The van Halem Group There are a number of signs that are pointing to an increase in audit activity across multiple payers as the public health emergency (PHE) winds down. These increases can be expected not just...

Read Full Post

Coming Soon: PECOS 2.0

CMS recently announced several updates to the online Provider Enrollment Chain and Ownership System (PECOS). Beginning this summer, PECOS will unveil the latest version, touted by CMS to make the process of applying to “become a Medicare provider...

Read Full Post

Industry Veteran Kit Shellhouse Joins The van Halem Group

Atlanta, GA – Kit Shellhouse, formerly of ECS North and ACU-Serve, has joined The van Halem Group, a division of VGM Group, as the Director of Business Development. With her client-focused approach and more than 20 years of experience in the...

Read Full Post

Power Mobility Device (PMD) Accessory Voluntary Prior Authorization

CMS added the following PMD accessory HCPCS codes for voluntary authorization. The goal of this process is to increase operational simplicity by allowing suppliers to request prior authorization for a PMD accessory. The DME MACs will begin accepting...

Read Full Post

Updating your provider enrollment file? Use the current 855-S...or else!

CMS recently updated the 855-S DMEPOS supplier application, effective January 9, 2023. The new form can be found on the CMS Forms List and is currenlty being accepted for new enrollments and changes of information.  The National Provider Enrollment...

Read Full Post