On May 13, 2024, CMS published updates to the Master List of items that require a face-to-face encounter and written order prior to delivery (WOPD). In...
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Recent Blog Posts
May 15, 2024
On May 13, 2024, CMS published updates to the Master List of items that require a face-to-face encounter and written order prior to delivery (WOPD). In addition, CMS updated the Required Prior Authorization List, to include nine additional codes that...
March 19, 2024
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...
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....
November 22, 2023
Every year from mid-November through December 31, providers can decide if they want to participate in Medicare for the upcoming year. In early to mid-November, your MAC will send a post card reminding you about the annual participation open enrollment...
October 19, 2023
CMS announced that, effective January 1, 2024, suppliers will be able to bill CGM supplies in 90 day increments. According to change request CR13397, the purpose of this Change Request (CR) is to instruct Medicare Administrative Contractors...
Audit Alert: SMRC adds lumbar-sacral orthoses to current projects list
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)...
October 6, 2023
Compliance DME FAQs General Blog Posts Orthotics Prosthetics Provider Enrollment
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...
October 5, 2023
On Thursday, October 5, 2023, CMS announced that the last day the National Supplier Clearinghouse (NSC) will accept provider enrollment appeals and rebuttals is Friday, October 6, 2023. Beginning Monday, October 9, 2023, all provider...
October 3, 2023
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)...
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...