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Telehealth flexibilities to expire at end of year without congressional intervention

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B...

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Medicare Provider Enrollment Updates: What you need to know NOW!

The Centers for Medicare & Medicaid Services (CMS) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations. Specifically, updates have been made to Medicare’s provider and supplier...

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Friday FAQ

Question: I am just starting a new home medical equipment business. How can The van Halem Group help? Answer: At vHG, we offer a variety of services for new DMEPOS suppliers, including assistance with getting your business accredited and enrolled...

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Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization
Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization

By Kelly Grahovac, General Manager, The van Halem Group In recent months, the Office of Inspector General (OIG) has been working to update their compliance guidance. This was first apparent in the revisions made to corporate integrity agreements (CIAs)...

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Power Mobility Device (PMD) Accessory Voluntary Prior Authorization

CMS added the following PMD accessory HCPCS codes for voluntary authorization. The goal of this process is to increase operational simplicity by allowing suppliers to request prior authorization for a PMD accessory. The DME MACs will begin accepting...

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Final Continuous Glucose Monitor (CGM) policy released

Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with...

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CGM coding changes for 2023

Effective January 1, 2023, claims submitted to Medicare for continuous glucose monitor (CGM) receivers, supplies and accessories using codes K0553 and K0554 will be rejected. These codes are discontinued on 12/31/2022. Suppliers that provide CGM devices...

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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...

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DOJ recovered over $5.6 Billion in 2021 – Over $5B related to health care industry

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...

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Accreditation up to date? Find out on your remittance notices beginning January 3, 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...

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