Home Blog

default blog image
Important Provider Enrollment Updates

Recently, the CMS made updates to the Medicare Enrollment chapter of the Program Integrity Manual. These changes are effective December 5, 2022.  Notable...

Read Full Post

Recent Blog Posts

Important Provider Enrollment Updates

Recently, the CMS made updates to the Medicare Enrollment chapter of the Program Integrity Manual. These changes are effective December 5, 2022.  Notable changes include updated provider enrollment instructions for:  Ownership disclosures Electronic...

Read Full Post

CMS issues guidance on post PHE audits

The CMS Center for Program Integrity (CPI) posted an FAQ this week on their Spotlight page titled “Medicare Fee-for-Service Claims Review When the Public Health Emergency Ends”. From the post... Q. At the end of the Public Health Emergency...

Read Full Post

National Provider Enrollment (NPE) DMEPOS Transition Starts Today!

Effective today, November 7, 2022, DMEPOS suppliers will be required to submit enrollment applications to either the NPE East (Novitas Solutions) or NPE West (Palmetto GBA) contractors. DMEPOS activities for suppliers located east of the Mississippi River...

Read Full Post

Updating your general liability insurance? You may need to change the certificate holder!

On Thursday, September 29, 2022, CMS formally announced the transition from the National Supplier Clearinghouse (NSC) to two new National Provider Enrollment Contractors (NPEC), Novitas Solutions (NPEast) and Palmetto GBA (NPWest). The contract...

Read Full Post

CMS announces new Enrollment Contractor

On Thursday, September 29, 2022, CMS formally announced the transition from the National Supplier Clearinghouse (NSC) to two new National Provider Enrollment Contractors (NPEC).  November 6, 2022, is the last day that the National Supplier Clearinghouse...

Read Full Post

Kelly Grahovac Joins Big Sky Board of Directors

Atlanta, GA – The van Halem Group is excited to announce that Kelly Grahovac, General Manager, has been named as an Associate Director to the Big Sky Association of Medical Equipment Suppliers Board of Directors. “I’m honored and...

Read Full Post

CMS announces the elimination of CMNS and DIFs

In the weekly CMS MLN Newsletter published Thursday, May 5, 2022, CMS announced,  “Suppliers, billers, and vendors: Certificates of medical necessity (CMNs) and the durable medical equipment (DME) information forms (DIFs) are discontinued...

Read Full Post

Heartland Sneak Peek: COVID Flexibilities Are Now Audit Opportunities

By Wayne van Halem, President, The van Halem Group One of the biggest uncertainties of moving into a post-pandemic world is how CMS will decide to audit claims submitted during the public health emergency. There were a number of “waivers”...

Read Full Post

PHE Extended Another 90 Days

On Tuesday, April 12, 2022, HHS Secretary Xavier Becerra announced an extension of the COVID-19 Public Health Emergency (PHE). This extension will last another 90 days from April 16, 2022. Any PHE declaration can only last for 90 days at a time...

Read Full Post

The Return of the RACs

By Wayne H. van Halem, AHFI, CFE, President, The van Halem Group The Recovery Audit Contractor (RAC) Program wreaked havoc in the DMEPOS industry from 2011 until about 2015 when they were essentially given free rein to audit DMEPOS claims. ...

Read Full Post