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Reminder: Payment edits for custom fitted orthotics go in effect October 1, 2021

Effective for dates of service on or after October 1, 2021, if a supplier is located in one of the states listed below and wishes to bill Medicare for...

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Reminder: Payment edits for custom fitted orthotics go in effect October 1, 2021

Effective for dates of service on or after October 1, 2021, if a supplier is located in one of the states listed below and wishes to bill Medicare for certain orthoses coded as OR01 (Orthoses: Custom Fabricated) and OR02 (Orthoses: Prefabricated, Custom...

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Settlement Conference Facilitation Expansion 2021

By Sandra Gauron, Appeals Coordinator The Centers for Medicare & Medicaid Services (CMS) has provided an alternative dispute resolution to filing an appeal to an Administrative Law Judge (ALJ) in order to prevent backlog since July 2014. The Settlement...

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Provider Enrollment Activities to Resume

In this week’s MLN Matters Newsletter, CMS announced that, beginning October 2021, some provider enrollment activities that were paused during the COVID-19 public health emergency will resume, including: Application Fees  Criminal...

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CMS announces TPE audits to resume

In the most recent issue of the CMS MLN Connects Newsletter, CMS announced that they are restarting the Targeted Probe and Educate (TPE) program. The program, which was established with a goal to “help educate providers and reduce...

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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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