Recently, the CMS made updates to the Medicare Enrollment chapter of the Program Integrity Manual. These changes are effective December 5, 2022. Notable...
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December 5, 2022
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...
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...
November 7, 2022
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...
October 19, 2022
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...
September 29, 2022
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...
September 26, 2022
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...
May 5, 2022
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...
April 27, 2022
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”...
April 13, 2022
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...
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. ...