Category
On April 28, 2025, CMS awarded Cotiviti GOV Services LLC, the new RAC Recovery Audit Contractor (RAC) Region 3, 4, and 5 contracts. RAC Region 5 includes jurisdictions: JA, JB, JC, JD, as well as the HH/H MACs: J6, J15, JK, and JM.
Performant,... Noridian Healthcare Solutions, LLC (Noridian), as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid (CMS), announced that they are conducting post-payment review of Medicare DME surgical dressing claims billed... December 16, 2024 The HME industry is a vital part of the healthcare ecosystem, providing essential services and equipment to patients in need. However, navigating the complex landscape of audits and compliance can be challenging. While the goal is to grow your HME business,... November 21, 2024 Noridian Healthcare Solutions, LLC (Noridian), as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid (CMS), announced that they are conducting post-payment review of Medicare DME intermittent... October 16, 2024 The Office of Inspector General (OIG) added two new DMEPOS items to their Work Plan for October 2024. See below for details.
Medicare Payments to Suppliers for Oxygen and Oxygen Equipment
Medicare covers reasonable and necessary durable medical... September 20, 2024 This post was originally featured in HME News.
Q. Should I be performing regular audits of my provider enrollment record?
A. Short answer, yes! Providers should review, or audit, their Provider Enrollment Record at least annually. In... March 13, 2024 By Wayne van Halem, President, The van Halem Group
What can you expect to see from an audit and compliance perspective in 2024? I think it’s going to be an interesting year. There are a number of things happening that could impact our clients.... Noridian Healthcare Solutions, LLC, (Noridian) as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid Services (CMS), is conducting post-payment review of claims for select Medicare Durable Medical Equipment (DME)... September 27, 2023 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... July 12, 2023 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...