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February 4, 2022 On February 1, 2022, the Department of Justice (DOJ) announced on their website that they had obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending... January 4, 2022 To supply Medicare DMEPOS to patients and to obtain and retain a supplier billing number, suppliers must adhere to the DMEPOS supplier and quality standards and accreditation requirements. In compliance with supplier standards, all changes to... October 19, 2020 By Kelli Ogunlesi, CHP, HIPAAwise Success Manager
The last week of September proved to be a very busy one for the Office of Civil Rights (OCR), the federal agency responsible for enforcing HIPAA privacy and security rules. From September 21 through... August 6, 2020 Today, CMS released more details on the medical review program since announcing audits would resume on August 3. This week's CMS MLN Connects newsletter included the headline "MACs Resume Medical Review on a Post-Payment Basis".
In the article, it... July 21, 2020 In recent meetings with CMS, we have learned that while the date to begin medical review functions is August 3rd, there will likely be a delayed time frame before audit requests officially go out. CMS is currently working to develop instructions for... June 29, 2020 CMS has updated the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131). Providers can use the new form now, and mandatory use of the form will be on 8/31/2020. The form is valid through 06/30/2023. On or after 8/31/2020, issuing an ABN... April 20, 2020 By Wayne van Halem, AHFI, CFE, President of The van Halem Group
As an Accredited Healthcare Fraud Investigator and Certified Fraud Examiner, I must attend courses to obtain CEUs to maintain my accreditation and certification. I attended one last week... February 5, 2020 By Carrie Nienberg, RN Clinical Director
CMNs for Oxygen, Pneumatic Compression Devices, Osteogenesis Stimulators, Transcutaneous Electrical Nerve Stimulator (TENS), Seat Lift Mechanisms, External Infusion Pumps, Enteral and Parenteral nutrition,... January 16, 2020 On January, 1 2020, CMS made it effective that only one type of order is needed for DMEPOS claims, in an effort to help reduce supplier and provider burden. As such, the preliminary/dispensing order, Detailed Written Order (DWO), Five Element Order (5EO)/Written... January 6, 2020 In the SMRC's (Supplemental Medical Review Contractor) most recent current project detail for Diabetic Test Strips, they include verbiage that not only impacts the DME supplier, but also the ordering practitioner.
Specifically the SMRC's current...