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Medicare Audit Issues Provider Survey: Please Complete! - 9/3/2010
In order to track the impact of increased audits that target the HME sector, AAHomecare is distributing the attached “Medicare Audit Issues Provider Survey” to all state associations and i (more...)
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CMS Releases Supplier Standards Final Rule - 8/31/2010
CMS released today a Final Rule that adds to and revises the existing supplier standards. More information is to come, but according to CMS, the Final Rule makes the following changes to the DME (more...)
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UPDATED: VGM User-Friendly PECOS Database! - 8/17/2010
The text file has been updated as of August 15.
VGM Members can The article linked below was posted by The Center for Regulatory Effectiveness. The Advanced Medical Technology Association is asking FDA and CMS to coordinate efforts to dispell mixed messages (go to source...)
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"Do I Want This Competitive Bidding Contract?" Free Web Presentation is NOW AVAILABLE - 7/9/2010
Presented by:
John Gallagher, VP-Government Relations
Alan Morris, Regulatory Analyst
This program offers valuable and timely information to providers currently being off (more...)
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CMS Expected to Announce “Winning” Bids on June 25 - 6/11/2010
AAHomecare has reported that CMS is likely to announce “winning” bids for the Medicare bidding program on June 25. (more...)
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FTC Extends Enforcement Deadline for Identity Theft Red Flags Rule - 6/1/2010
As many HME providers are aware, on May 28 the Federal Trade Commission announced it would delay enforcement of the Red Flags Rule from June 1 to Dec. 31, 2010. (more...)
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PECOS Access for HMEs Coming Soon; "Getting Started Guide" Now Available - 5/27/2010
CMS will soon provide access to Internet-based Provider Enrollment, Chain and Ownership System (PECOS) to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) who are (more...)
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1/3/11 Referring-Physician PECOS Requirement Still Stands - 5/24/2010
From HomeCare Monday
After scrambling for months to make sure their referring and ordering physicians are enrolled in PECOS, DMEPOS providers will be able to use the Internet-based system to manage enrollment for themselv (more...)
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Red Flag Rules Effective June 1; AMA and Others File Suit Against FTC - 5/24/2010
Commentary by VGM, Article Provided by Information Law Group
Red Flags Rules are scheduled to go effective June 1, 2010. At that point, all “creditors” are required to have programs in place to combat identity theft. As regulation currentl (more...)
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Competitive Bidding Still Talk of the Town - 5/17/2010
Homecare Monday, 5/17/10
LAS VEGAS--As the reality of Round 1 grows closer—CMS should release pricing in June—the hottest topics at Medtrade Spring last week were competitive bidding, competitive bidding and compe (more...)
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Attention Round One Bidders: CBIC Requesting Information Regarding Licensure - 4/28/2010
Yesterday, CBIC began sending out E-mails requesting additional information regarding state licensure. If you bid in a CBA that requires licensure for the product category(s) for which you bid, (more...)
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DME Providers Who Submitted Bids for the First Round of Competitive Bidding - 4/23/2010
CBIC is currently in the process of evaluating bids and computing composite bids. This is the first step of the contracting process for round one bidding entities. (more...)
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VGM/HME News Round One Competitive Bidding Survey - 3/31/2010
Dear Round One Bidders:
Please participate in this brief VGM/HME News survey on the Round One Competitive Bidding process. The survey will help us predict winning bid amo (more...)
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Updated PECOS Physician Letter - 3/4/2010
In response to the recent annoucement of the delay in PECOS implementation, National Government Services has released an updated letter for physicians.
(more...)
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Competitive Bidding Will Cost More Than 100,000 Jobs - 2/24/2010
Summary: The expanded competitive bidding program, proposed in up to 100 U.S. metropolitan areas, is estimated to cost more than 100,000 jobs. The selective contracting progr (more...)
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PECOS Delayed Until 2011! - 2/19/2010
Announcement from CMS` James Bossenmeyer
Jim Bossenmeyer, Director of CMS’ Division of Provider and Supplier Enrollment announced on today’s special “Open Door Forum” that Medicare will delay implementation of CR6417 (more...)
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PAOC Meeting Delayed Until March 17 - 2/19/2010
The Program Advisory and Oversight Committee (PAOC) meeting originally scheduled for February 23, 2010 has been postponed until March 17, 2010 due to logistical issues, including meeting registration (more...)
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Commentary on HITECH Act Provisions Effective February 17, 2010 - 2/10/2010
VGM provides BAA Template
February 5, 2010 Health Law Alert
As you are no doubt aware, on February 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act of 2009, which included the (more...)
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Important ZPIC Audit Clarification - 2/9/2010
On Monday, January 25, VGM posted an article titled “Preparing for ZPIC Audits” that contained a linked Word document. (“Preparing for an Audit, How to Respond to a Review (more...)
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Preparing for ZPIC Audits - 2/8/2010
Medicare fraud and abuse prevention and detection efforts are about to get tougher because of the new Zone Program Integrity Contractors (ZPIC). According to CMS, ZPICs were developed to fix fla (more...)
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ZPIC Audits Newest `Business Buster,` Stakeholders Say - 1/25/2010
From HomeCare Monday
RAC, CERT, ZPIC, take your pick. HME providers are now finding themselves the targets of multiple Medicare audits that, at least in some cases, threaten to cripple th (more...)
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Last Day to Bid for the Round 1 Rebid of the DMEPOS Competitive Bidding Program - 12/21/2009
VGM analysts Mark Higley and Alan Morris will be On Call until the bidding deadline at 11:59 P.M. EST tonight! They`ll be happy to help members with their last-minute bidding quest (more...)
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PECOS Letter for Physicians - 12/21/2009
As of April 5, 2010, DMEPOS suppliers will not be receiving payment from Medicare for items that are ordered if you are not currently enrolled in the Medicare Provider Enrollment, Chain and Ownership (more...)
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IMPORTANT - REMEMBER TO CERTIFY FORM B! - 12/21/2009
If you are a supplier interested in participating in the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program, please reme (more...)
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Understanding the Bidding Process: Supplier Capacity, Beneficiary Demand, and Effect of Weighted Bids - 12/18/2009
Commentary provided by Alan Morris, Regulatory Analyst, VGM
Many Members have contacted VGM over the past several weeks with questions concerning capacity, bid weights, and bid calculation as they pertain to the Medicare competitive bidding program. As a (more...)
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Help Us Work With CMS on Retroactive Billing Privileges - 12/16/2009
VGM posted the story below, on December 10, 2009, and now we would like you to follow up on this message. If you are a provider who applied for accreditation by Jan. 31, 2009 and did not complete accr (more...)
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Only 10 Days Left to Bid for the Round 1 Rebid of the DMEPOS Competitive Bidding Program - 12/11/2009
The Centers for Medicare & Medicaid Services (CMS) is currently accepting bids for the Round 1 Rebid of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bid (more...)
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Saturday is the LAST DAY to Qualify for the Covered Document Review Process for the Round 1 Rebid - 12/9/2009
From CBIC
Reminder: If you are a supplier bidding in the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, you must submit (more...)
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Despite Delay, PECOS Remains `Mission Critical` - 12/7/2009
From HomeCare Monday, December 7, 2009
COLUMBIA, S.C.--Even though CMS has delayed the PECOS physician registration requirement until April 5, 2010, industry consultant Andrea Stark is counseling HME companies not to slow down on educating (more...)
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Know of Providers Going Out of Business or Giving Up Their Medicare Patients Due to New Regulations? VGM Wants You to Share Your Stories! - 12/3/2009
If you are aware of local DME providers, or are in a situation yourself where a provider has gone out of business or given up their Medicare patients due to any of the number of recent changes to CMS (more...)
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PECOS Implementation Delayed Until April 5th - 11/24/2009
This afternoon, CMS announced the much anticipated delay of Phase 2 of PECOS implemnation. The following is today`s announcement from CMS:
(more...)
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CRE Encourages Suppliers and Beneficiaries to Submit Formal Complaints to CMS about DME Competitive Bid Program - 11/24/2009
CMS provides three different channels through which DMEPOS suppliers and beneficiaries may submit formal complaints about the DME competitive bidding program. The Center for Regulatory Effectiven (more...)
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CMS Responds to PECOS Warning Edits - 11/5/2009
This message is directed at Medicare suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), their billing agents and clearinghouses, and the physicians and non-physicia (more...)
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Last Day to Register for the Round One Rebid of the DMEPOS Competitive Bidding Program - 11/4/2009
Reminder: Suppliers interested in participating in the Round One Rebid of the Medicare DMEPOS Competitive Bidding Program must register today (November 4, 2009) before 9:00 p.m. EST. Suppliers w (more...)
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Provider Enrollment, Chain and Ownership System (PECOS) and DME - 10/29/2009
Questions and Answers to Assist in Clarifying the Program
As of Oct. 1, physician and non-physician practitioners must be enrolled in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and of the type/specialty eligible to order/refer servi (more...)
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Fight Fraud with FEAT! - 10/23/2009
The VGM Group, Inc. is happy to announce the launch of a new Web site for the Fraud Eradication Advisory Team (FEAT), which was formed in conjunction with a group of industry stakeholders as an effort (more...)
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BIDDING IS NOW OPEN FOR THE ROUND 1 REBID OF THE DMEPOS COMPETITIVE BIDDING PROGRAM - 10/21/2009
The Centers for Medicare & Medicaid Services (CMS) is now soliciting bids for the Round One Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competiti (more...)
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NSC Rejections of Surety Bond/Accreditation Notification - 10/8/2009
VGM has become aware that some providers have had their surety bonds or accreditation notification rejected by the National Suppliers Clearinghouse (NSC), leaving them at risk for losing their billing (more...)
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Medicare DMEPOS Competitive Bidding Program Bidders` Conference is Today! - 10/7/2009
Bid Submission Process
CMS will have the sixth in a series of eight Special Open Door Forum (ODF) bidders’ conferences for the Round One Rebid of the Medicare DMEPOS competitive bidding program. At this Special (more...)
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Medicare`s DME Accreditation: Update and Comments from Alan Morris, VGM Regulatory Analyst - 9/29/2009
This week hundreds of home medical equipment providers are frantically scrambling to submit a “voluntary termination” of their PTAN billing number due to Thursday’s Oct. 1 deadline.& (more...)
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CMS Special ODF for Competitive Bidding Program is TOMORROW (9/29) - 9/28/2009
“How a Bid is Evaluated”
The fifth in a series of Special Open Door Forums (ODF), which serve as bidders` conferences to provide information on the Medicare DMEPOS Competitive Bidding Program will be held on September 29, (more...)
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CRE Meets with CMS about Accreditation – NO EXTENSION - 9/28/2009
Last week, the Center for Regulatory Effectiveness (CRE) met with CMS representatives to discuss its request for an extension of the accreditation deadline. The request may be found on the CRE Web sit (more...)
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Surety Bond / Accreditation Reminder: - 9/22/2009
DON’T RISK LOSING YOUR MEDICARE BILLING PRIVILEDGES!
ACCREDITATION AND SURETY BOND DEADLINES ARE APPROACHING!
The National Suppliers Clearinghouse (NSC) has indicated that it may revoke the billing privileges of (more...)
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REMINDER: CMS Special ODF - Financial Documentation Plus Small Supplier Considerations is Sept. 22 - 9/21/2009
The fourth in a series of eight Special Open Door Forum (ODF) bidders’ conferences for the Round One Rebid of the Medicare DMEPOS Competitive Bidding Program will be held on Tuesday, Sept. 22 fr (more...)
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Upcoming Competitive Bidding Deadlines - 9/18/2009
The target deadline for Authorized Officials (AOs) to register for the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding progra (more...)
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CMS Announces Third Special ODF for Competitive Bidding - 9/14/2009
“What You Need to Know Before Submitting Your Bid”
The Centers for Medicare and Medicaid Services (CMS) has announced their third in a series of eight Special Open Door Forum (ODF) bidders’ conference for the Round One Rebid of the Medicare DMEP (more...)
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CRE Requests CMS Extension of DMEPOS Supplier Accreditation Deadline - 9/10/2009
On Sept. 9, Center for Regulatory Effectiveness (CRE) board of advisors member, Jim Tozzi wrote a letter to the CMS Acting Administrator, Charlene Frizzera, requesting an extension of the Oct. 1 DMEPO (more...)
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IMPORTANT INFORMATION ABOUT SURETY BONDS AND ACCREDITATION - 9/3/2009
NOTICE TO VGM MEMBERS:
Regarding “Medicare Supplier Standards and Procedures Resources Guide for DME, Rehab and O&P Providers”
In late July and early August, V (more...)
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REMINDER: "Rules for Submitting a Bid" Special Open Door Forum is Today! - 9/2/2009
Powerpoint available on Web site
The second in a series of Special Open Door Forums (ODF), which serve as bidders` conferences to provide information on the DMEPOS Competitive Bidding Program, will be held on September 2, 2009, from (more...)
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CMS Offers Guidance on Subcontracting in Competitive Bidding - 9/2/2009
On Sept. 2, CMS held its second in a series of Special Open Door Forums (ODF) to provide information about the re-bid of the first round of the DMEPOS Competitive Bidding program. Facilitators of (more...)
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Special ODF: How to Register to Access the Bidding System is on Aug. 19 - 8/18/2009
REMINDER: The first in a series of Special Open Door Forum (ODF) bidders` conferences for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competi (more...)
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CMS Changes Consignment Closet Rules - 8/17/2009
From HomeCare Monday
On Aug. 7, CMS issued a change request transmittal on consignment closet rules, and there are definitely some big changes, according to health law attorney Jeff Baird. (more...)
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Registration is Now Open for Suppliers Interested in Competitive Bidding For DMEPOS - 8/17/2009
Registration is now open and available to all suppliers interested in participating in the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Compet (more...)
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Medicare Announces Timeline for Bidding - 8/10/2009
October 21, 2009 is Target Date for 60-Day Bid Window Opening
The Centers for Medicare & Medicaid Services (CMS) has announced the bidding timeline for the Round 1 Rebid of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (more...)
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FTC to delay `red flags` enforcement until Nov. 1 - 7/29/2009
July 29, 2009
Moving an Aug. 1 deadline, the Federal Trade Commission will wait until Nov. 1 to enforce a provision of the “red flags” rule requiring virtually all health ca (more...)
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IMPORTANT ACCREDITATION AND SURETY BOND UPDATE! - 7/27/2009
VGM encourages all suppliers to review and update the National Supplier Clearinghouse (NSC) with accreditation and/or surety bond information via the CMS-855S form.
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Continue Submitting Comments to CRE - 7/20/2009
Continue submitting your comments on the DMEPOS Competitive Bidding Program to the CRE website. (more...)
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CRE Uncovers Discriminatory Actions by CMS on DME Competitive Bidding - 7/16/2009
CRE Needs Your Comments - Submit Them Today!
The Center for Regulatory Effectiveness (CRE) is seeking comments on a letter that was recently sent to OMB Deputy Director Jeffrey Zients. The July 14 letter, sent from CRE board of director me (more...)
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Obama Proposes New Agency That Would Set Reimbursement Rates - 7/16/2009
American Health Line, 7/16/09
The White House on Wednesday began circulating draft legislation that would create a new executive agency to oversee Medicare reimbursement rates and policy changes, Politico reports. Under the (more...)
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DMEPOS Supplier Accreditation and Surety Bond Requirement - 7/7/2009
Suppliers May Choose to Voluntarily Terminate Enrollment If They Do Not Plan To Comply
Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), unless exempt, must be accredited and obtain a surety bond by October 1, 2009 and October 2, 2009, respec (more...)
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VGM ANNOUNCES REVISED COMPETITIVE BIDDING - 6/16/2009
CMS has released an email outlining its “next steps” of the implementation of the Round One rebid of competitive bidding.
The announcement included an update of the general timeline of the bidding process. According to CMS “The bidder registration period is expected to begin this summer before bidding opens in the (more...)
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Competitive Bidding to Open in Fall 2009 - 5/29/2009
CMS Says, "Get Ready for Competitive Bidding!"
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), enacted on July 15, 2008, made limited changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (more...)
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DME Comp Bidding Rebid Nears, Stakeholders Seek Program Changes - 5/28/2009
Ashley Richards, Inside Health Policy
Durable medical equipment (DME) suppliers and regulatory watchdogs are urging CMS to administratively reform its competitive bidding program before beginning the round 1 rebid -- the time frame for wh (more...)
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PAOC Meeting on the Implementation of the Medicare DMEPOS Competitive Bidding Program - 5/11/2009
The Centers for Medicare & Medicaid Services (CMS) will be hosting a meeting with the Program Advisory and Oversight Committee (PAOC) on June 4, 2009 to discuss the Round 1 Rebid of the Medicare D (more...)
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First Surety Bond Deadline Today - 5/4/2009
HomeCare Monday, May 4, 2009
As of today, HME companies applying for a new National Provider Identifier must have a $50,000 surety bond in order to be approved as a Medicare provider. (more...)
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New PAOC Members Hopeful as First Meeting Approaches - 5/4/2009
HomeCare Monday, May 4, 2009
Members of the second Program Advisory and Oversight Committee said Friday they are hopeful they can have a positive impact on DMEPOS competitive bidding as the rebid process moves forward. (more...)
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Important June 1 Update: Revised CMS-855S Enrollment Application - 4/30/2009
Effective June 1, 2009 DMEPOS suppliers submitting applications to Medicare must use the revised CMS-855S form. Applications submitted after June first using the old 855-S form will be rejected. (more...)
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Pilot Program Aims To Reduce Hospital Readmissions - 4/16/2009
American Health Line
CMS recently announced a nationwide pilot program, the Care Transitions Project, that aims to reduce preventable hospital readmissions for Medicare beneficiaries, Providers in the remaining Round One competitive bidding areas should get ready for a rebid. That was the advice from VGM Group’s Mark Higley during a March 25 session at Medtrade Spring in Las (more...)
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Open Door Forum Addresses Surety Bond Issues - 4/6/2009
From HomeCare Monday; April 6, 2009
At an Open Door Forum on Wednesday, CMS officials ticked through a raft of important dates for DMEPOS providers on accreditation, the interim final rule on competitive bidding, the Recovery Audit Cont (more...)
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Sources: Billings Clinic CEO Could Be Tapped To Lead CMS - 4/6/2009
Brett Coughlin, Inside Health Policy, 4/2/09
A physician and CEO of Billings (Montana) Clinic, Nicholas Wolter, is being considered as the next CMS administrator, Washington insiders tell Inside CMS. Billings Clinic spokesman Jim Duncan confirme (more...)
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A Second HHS Secretary Nominee Facing Tax Problems; Potentially Bad News for the HME Industry - 4/6/2009
It was reported yesterday that HHS Secretary nominee Kathleen Sebelius (D-KS) had corrected three years of tax returns and paid almost $8,000 in back taxes and interest. While the Obama administ (more...)
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CMS Releases New Instructions on Payment for Maintenance and Servicing of Oxygen Equipment Post 36-month Cap - 3/27/2009
In its transmittal dated March 20, 2009, CMS provided payment instructions for oxygen equipment eligible for maintenance after the 36-month rental cap. (more...)
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CMS Says Surety Bond Requirement Will be Implemented by Existing Deadlines - 3/19/2009
Courtesy of AAHomecare
During the special open door forum today, Centers for Medicare and Medicaid Services (CMS) officials stated the surety bond requirement will be implemented beginning May 4, 2009 for new HME providers (more...)
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Deadline to Submit Comments on Competitive Bidding IFR was March 17, 2009 - 3/18/2009
The last day to submit comments on the competitive bidding interim final rule is Tuesday, March 17, at 5 p.m. Eastern Time. (more...)
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DMEPOS Accreditation – Get It Now - 3/12/2009
Deadline is September 30, 2009
CMS has reminded providers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who bill Medicare under Part B must obtain accreditation by September 30, 2009. (more...)
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REMINDER: Deadline to Submit Comments on Competitive Bidding IFR is Next Week - 3/9/2009
The last day to submit comments on the competitive bidding interim final rule is Tuesday, March 17, at 5 p.m. Eastern Time. (more...)
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CMS Special Open Door Forum - 3/6/2009
Surety Bond Requirement for DMEPOS Suppliers
Tuesday, March 17, 2009 2:00PM – 3:30PM ET (more...)
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Important Oxygen Updates - 3/3/2009
Includes Q&A, sample beneficiary letters, and VGM analysis. (more...)
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`No Ifs, Ands or Buts` on Competitive Bidding - 2/23/2009
From HomeCare Monday
Despite a 60-day delay of the competitive bidding interim final rule, the Medicare bidding project will move forward and Round One will be rebid this year. That was the word from CMS’ Joel Kaise (more...)
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CMS Delays Competitive Bidding Rule 60 Days - 2/16/2009
Just a day after comments regarding the notice of delay for the Interim Final Rule on competitive bidding were due, CMS announced that the effective date of the rule (CMS-1561-IFR) (more...)
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The Deadline to Submit Your Comments to CMS on the Contemplated Delay of the Competitive Bidding Interim Final Rule is TODAY! - 2/12/2009
CMS Considers Delay of the Effective Date of Interim Final Rule on Competitive Bidding.
In accordance with the Jan. 20 memorandum from President Obama’s Chief of Staff, Rahm Emanu (more...)
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Oxygen Questions Remain Unanswered - 2/5/2009
Alan Morris, Regulatory Analyst, VGM
I recently asked a CMS representatives a few questions about some currently pressing issues for oxygen providers. Please see the questions and answers below. (more...)
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ACTION ALERT: DMEPOS Accreditation Deadline is September 30, 2009 - 1/30/2009
Have you submitted your applications?
CMS has recommended that providers have their applicati (more...)
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REMINDER: CMS Recommends Suppliers Apply for Accreditation by January 31 - 1/26/2009
CMS, in preparation for the September 30 accreditation deadline, has recommended DMEPOS suppliers apply for accreditation no later than January 31. (more...)
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Obama`s Administration Halts New Regulations until Reviewed - 1/26/2009
White House Chief of Staff, Rahm Emanuel has informed all federal agencies that any pending rules will not move forward until Obama’s administration can review each one. This means that the new (more...)
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CMS to Process Some Supplier Numbers in November - 1/22/2009
CMS to review new numbers on case-by-case basis
BALTIMORE-- Responding to concerns regarding the NSC provider-number moratorium, Centers for Medicare and Medicaid Services Administrator Tom Scully said the agency will process some provide (more...)
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DMEPOS Accreditation Deadline Round 2 Announcement - 1/22/2009
GET ACCREDITED FOR DMEPOS COMPETITIVE BIDDING!
In order to participate in the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program, suppliers must mee (more...)
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New Tip Sheet for Referral Agents under the DMEPOS Competitive Bidding Program - 1/22/2009
Medicare providers in the 10 Competitive Bidding Areas (CBAs) who order or refer Medicare beneficiaries for Durable Medical Equipment, Prosthetics, Orthotics, and Suppli (more...)
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CANCELED - 1/22/2009
ACCREDITATION Deadlines FOR DMEPOS Competitive Bidding
A message from CMS…
The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. This n (more...)
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Danger, Opportunity Await Respiratory Suppliers Who Contract with Medicare Oxygen Patients After 36 Months - 1/22/2009
(more...)
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Changes to Competitive Bidding Final Rule are Minor, Suppliers Urged to Comment - 1/22/2009
Alan M. Morris, Regulatory Analyst, VGM
CMS released its much-anticipated interim final rule for the DMEPOS competitive bidding program this morning. As feared by many in the supplier community, the new regulations offer little in the way (more...)
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CMS Releases Interim Final Rule for Competitive Bidding - 1/15/2009
VGM has received notice that CMS has released the interim final rule for competitive bidding. (more...)
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CMS to Assess Providers’ ‘Potential for Fraud’ - 1/13/2009
HomeCare Monday, January 12, 2009
In a transmittal issued on New Year’s Eve, CMS said the National Supplier Clearinghouse Medicare Administrative Contractor will begin a “fraud potential analysis” of all DMEPOS applicants an (more...)
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Summary of Surety Bond Requirement Provisions - 1/6/2009
Alan M. Morris, VGM
As mandated by section 4312(b) of the Balanced Budget Act of 1997 (BBA), CMS is implementing section 1834(a)(16) of the Social Security Act (the Act), requiring the major (more...)
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CMS to Host Special Open Door Forum on DMEPOS Accreditation - 1/6/2009
REMINDER: CMS Recommends Suppliers Apply for Accreditation No Later Than January 31, 2009 to Ensure Completion by the September 30, 2009 Deadline (more...)
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VGM Seeks Information from Providers about Oxygen Service - 1/6/2009
As providers are aware, Jan. 1 marked the first day of the post-capped payment rules for oxygen. In an effort to track any issues or problems that may be encountered after the payment cap, (more...)
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New Study: Oxygen Providers to Lose $850M in 2009 - 12/22/2008
HomeCare Monday, December 22, 2008
Oxygen providers who bill Medicare will be about $850 million short in reimbursement in 2009, according to a new study on Medicare payment policy and home oxygen therapy. (more...)
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Medicare Open Enrollment Reminder - 12/18/2008
HME providers have likely received Medicare`s annual "Open Enrollment" letter from Palmetto GBA dated November 15, 2008. This letter has to do with “participation” status (more...)
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Outcry Grows Over New O2 Regs - 11/10/2008
HomeCare Monday, November 10, 2008
Following CMS’ Oct. 30 release of regulations involving changes to Medicare home oxygen policy and payment, some stakeholders involved in the sector said they believe the new rules (more...)
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Submit Your 0xygen Regulation Comments - 11/10/2008
CMS is accepting comments on the oxygen regulations until 5 p.m. EST Dec. 29. In commenting, refer to file code CMS-1403-FC. Comments can be submitted in one of four ways: (more...)
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CMS Announces Changes in Medicare Payments for Oxygen and Oxygen Equipment - 11/3/2008
(more...)
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Oxygen Answers Not What Industry Wanted to Hear - 11/3/2008
HomeCare Monday
For months, providers and other industry advocates have been asking CMS for guidance on numerous issues surrounding the 36-month oxygen rental cap, which becomes effective Jan. 1. (more...)
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Watch Those Emails: Oxygen Info Could Come This Week - 10/27/2008
(more...)
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ICD-10-CM/PCS National Provider Conference Call for Other Part A and Part B Providers - 10/22/2008
ICD-10-CM/PCS National Provider Conference Call for Other Part A and Part B Providers may now register for the Centers for Medicare & Medicaid Services ICD-10-CM/PCS Nati (more...)
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CMS Releases Final Quality Standards - 10/21/2008
Commentary from Mark Higley, VGM
CMS has issued its revised quality standards. Last week the agency held a 4 1/2-hour conference directed to DMEPOS providers that had not yet obtained accreditation. The Medicare Improvements for Pa (more...)
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OIG Aims at DME in 2009 Work Plan - 10/20/2008
From HomeCare Monday, October 20, 2008
In its Work Plan for 2009, issued earlier this month, HHS` Office of Inspector General said it will take on a number of DME investigations. (more...)
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OIG to Examine CPAP Payments - 10/17/2008
From HME Today Friday Report
As part of its Work Plan for FY 2009, the Office of Inspector General (OIG) will investigate Medicare payments for both sleep studies and CPAP devices. “Medicare payments for polysomnography (more...)
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Weems Targets ‘Rotten’ DME Suppliers - 10/8/2008
Medicare Expands Its Crackdown on Fraud, by Julie Applebee, USA Today, 10/7/08
Acting Medicare chief Kerry Weems on Monday announced new efforts to combat fraud in seven states, focusing on companies that improperly provide patients with medical equipment such as wheel (more...)
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PAP LCD: Comparison of Latest Revisions, Initial Provisions - 9/29/2008
From HomeCare Monday
While the DME MACs` re-issued PAP local coverage determination still prohibits HME providers` involvement in home sleep testing, the new LCD has been (more...)
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DME MACs Revise PAP LCDs - 9/24/2008
From Sleep Review, Wednesday, Sepember 24, 2008
The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have released revised Local Coverage Determinations (LCDs) for PAP devices for the (more...)
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DME MACs Issue ‘Kinder’ Sleep LCD - 9/22/2008
From HomeCare Monday
Weeks after tabling the Sept. 1 implementation date for the local coverage determination for PAP devices, the DME MACs last week issued a revised LCD that eased at least (more...)
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CMS Cautions Providers on Oxygen Equipment Rules - 9/22/2008
From HomeCare Monday
In an Open Door Forum Wednesday, CMS included a caution on repeal of the oxygen equipment transfer called for under the Medicare Improvements for Patients and Providers Act--althou (more...)
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VGM & Associates, along with its members and vendors, support the fight against DMEPOS Competitive Bidding - 9/5/2008
VGM, Invacare and numerous valued VGM Members donated to the Defeat Competitive Bidding Fund, created by AAHomecare to support litigation challenging CMS’ DMEPOS Competitive (more...)
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CMS Sets Call on Accreditation Exemptions, Answers Question on Hospice Rule - 8/25/2008
HomeCare Monday, August 25, 2008
The “drop dead” date for mandatory DMEPOS accreditation has been set for Sept. 30, 2009, but last week, CMS announced a Special Open Door Forum to address exemptions to the deadlin (more...)
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DME MACs Put a Hold on PAP LCDs - 8/25/2008
HomeCare Monday, August 25, 2008
In the latest development on PAP testing and policy, last week the four DME MACs delayed the Sept. 1 implementation date of their recent local coverage determinations on positive airway pres (more...)
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Positive Airway Pressure Devices LCD - Delayed Implementation - 8/19/2008
From CIGNA Government Services
In July, the DME MACs published a Local Coverage Determination (LCD) on Positive Airway Pressure (PAP) Devices for Obstructive Sleep Apnea. Some criteria in that policy were to take (more...)
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CMS` Open Door Mantra: `Send an E-Mail` - 8/18/2008
From HomeCare Monday
BALTIMORE--Industry stakeholders seeking answers to questions about accreditation, compensation for competitive bid winners and other home medical equipment issues for the most part came away empty-ha (more...)
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Oxygen Questions Remain Unanswered - 8/15/2008
(HME Today, Friday, August 15, 2008) by Rob Brant
Three weeks ago, AMEPA Board Member Barry Johnson, asked CMS how maintenance and other aspects of oxygen service would be covered in 2009 after the oxygen is capped (paid (more...)
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MAY 14: LAST DAY TO APPLY FOR ROUND TWO ACCREDITATION! - 5/13/2008
CMS will not accept bids from HMES that have not applied.
VGM is urging all homecare providers who are considering submitting a bid in "Round Two" of the competitive bidding program to verify that their facility has applied for DMEPOS acc (more...)
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Important Information about the Upcoming DMEPOS Competitive Bidding Program! - 4/29/2008
VGM highly encourages providers to participate in this call. It appears as though CMS has every intention of sticking to t (more...)
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Important Information for Medicare FFS Providers Regarding NPI - 4/29/2008
May 7 is "Legacy Free" Day - An opportunity to check your NPI readiness! (more...)
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Re: CMS "Bid Evaluation" and Documentation Deadline January 7 - 1/7/2008
IMPORTANT UPDATE!
On January 2, VGM posted information regarding an important deadline for all "Round One" bidding companies who (more...)
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Special Open Door Forum Announces September 30, 2009 Accreditation Deadline - 12/25/2007
Some providers still appear unclear on issues
(more...)
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NPI Warning! Some providers have inadvertently disclosed their social security numbers - 11/27/2007
Check now...and delete SSN immediately if applicable
CMS reports that some health care providers have reported their Social Security Numbers (SSNs), or the SSNs of other health care providers, in their NPPES records in fields that the Freedom (more...)
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DMEPOS Enrollment vs. Accreditation - 11/20/2007
Is There a Difference?
There has been some confusion over whether DMEPOS enrollment is different from CMS accreditation. If an HME company is enrolling as a DMEPOS supplier, (more...)
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Medicare Bidding for Durable Medical Equipment Will Harm Small Businesses and Seniors` Access to Care - 11/1/2007
American Association for Homecare Testifies
The Medicare bidding program for durable medical equipment will hurt small providers and "undermine the nation`s homecare infrastructure" unless Congress modifies the program. (more...)
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New NPI Rejections Effective October 29, 2007! - 10/29/2007
Medicare is rolling out its NPI crosswalk "tough love" program
Since October 2, 2006, providers have been encouraged to submit both the NPI and Medicare legacy identifier (PIN) on their claims. During this timeframe providers were not penalized for invalid NPI/le (more...)
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Public radio compares DME providers to drug dealers - 10/15/2007
Contact them now and tell them they’re very wrong!
The story, which ran Oct. 11, was reported by Greg Allen on “Morning Edition.” The full text is available below.
(more...)
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OIG Releases 2008 "Work Plan" - 10/9/2007
Includes "areas and issues that will be focused on in the coming year through audits, evaluations, and inspections"
The HHS Office of the Inspector General (OIG) has posted its 2008 Work Plan. In the plan, the OIG addresses health care fraud, and includes a statement that t (more...)
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The NSC "Top Ten" - 9/27/2007
Goal: Decrease processing times
80% of the enrollment documentation received by the National Supplier Clearinghouse (NSC) requires development for missing or incomplete information.
Most of this development is avoidable. The NSC en (more...)
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IMPORTANT COMPETITIVE BIDDING REMINDER - 9/25/2007
First-Round Bid Deadline Tonight; Official WebSite "Very Slow"
VGM reminds all HME providers participating in "round one" of the the Medicare Competitive Bidding Program that all bids are due by 9 p.m. EDT tonight (September 25, 2007). (more...)
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NSC Updates: Introducing the PTAN - 8/22/2007
Also: The DMEPOS Enrollment Process v. The Accreditation Process
Just when you thought there could not possibly be another acronym to memorize, here comes the PTAN. (more...)
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NPI Registry Now Set to Begin September 4, 2007 - 8/7/2007
CMS extending time for providers to view/edit NPPES data
NPPES health care provider data that are disclosable under the Freedom of Information Act (FOIA) will be disclosed to the public by CMS via the Internet. Data will be available in two forms: a query- (more...)
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CMS Special Bidders Conference on Competitive Bidding Addresses Technical Difficulties - 7/16/2007
Last Monday, the Centers for Medicare & Medicaid Services (CMS) hosted a special bidders conference to address some technical issues with the Competitive Bid Submission System (CBSS).
(more...)
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HHS Fights Durable Medical Equipment Fraud - 7/3/2007
Demonstration Project Targets Fraudulent Business Practices in South Florida and Southern California
On July 2 HHS Secretary Mike Leavitt announced a two-year effort designed to further protect Medicare beneficiaries from fraudulent suppliers of DMEPOS. (more...)
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CMS: National Provider ID info delayed a month - 6/28/2007
"CMS believes that health care providers need additional time"
Federal officials say they will not give providers and others looking for National Provider Identifier data the information they seek until Aug. 1. The Centers for Medicare & Medicaid Servic (more...)
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CMS releases NPI data notice - 5/30/2007
Providers may review information on Internet
CMS released a display copy of the much-anticipated National Plan and Provider Enumeration System (NPPES) Data Dissemination Notice (CMS-6060-N), which describes the policy for making NPPES (more...)
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Washington Post Article Reports HME Fraud; 38 Arrested in South Florida - 5/11/2007
VGM, AAHomecare take action to ensure press, policymakers cognizant of industry`s efforts
"Calling South Florida a particularly ripe area for Medicare fraud, federal prosecutors Wednesday announced a crackdown on sham medical care companies, inc (more...)
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VGM creates National Competitive Bidding Website - 4/23/2007
Find out what steps are needed for bidding
Whether you will bid as an individual provider, join a network or become a subcontractor, VGM has the tools to assist you.
Visit the site now
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First 10 MSAs target poor, minorities - 4/12/2007
Dear VGM Group Member:
I am writing this letter to all VGM Group Members in the first 10 Metropolitan Statistical Areas that will be affected by Competitive Bidding, and hope you will take the (more...)
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Senate Budget Committee discussion suggests continuing HME "scams" - 3/24/2007
Senator Conrad calls for "crackdown"
Below you will find AAHomecare’s write-up highlighting Senate Budget Committee Chairman and Senate Finance Committee member Kent Conrad`s fraud and abuse comments related to HME du (more...)
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CMS Developing Competitive Bidding Implementation Website - 3/23/2007
Multi-purpose site designed for suppliers, referral sources, beneficiaries
CMS announced on Thursday its newly established DMEPOS Competitive Bid (more...)
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"Why they won`t be accredited " - 3/6/2007
HME News Poll Results
Accreditation is too expensive, irrelevant, a waste of time and a problem to deal with on another day. So say providers who have yet to become accredited and don`t plan to begin the process in the for (more...)
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NSC Releases Updated "Model Forms" - 2/28/2007
Some confusion among providers results in updated forms required by supplier standards
"The attached model forms were created in an effort to educate suppliers regarding certain supplier standards listed in 42 C.F.R .424.57(c)." (more...)
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NSC Site Visit: What Should Suppliers Expect? - 2/19/2007
"Site visits, to many suppliers, seem to be one of the more daunting events that occur during the enrollment process"
The site visit along with the application and supporting documentation are considered in making a determination to issue, deny or revoke a supplier’s billing privileges. The answer (more...)
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DME Region A/B PSC Announce Power Mobility Device Update - 1/26/2007
TriCenturion releases update concerning the Basic Equipment Package
The highlights of this update follows. Industry analysts expect the other PSCs to issue a similar release shortly.
(more...)
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200 Miami HMEs Lose Provider Numbers, Homecare Magazine Reports - 1/23/2007
"Those actions...have put beneficiaries at risk"
Some 200 HME providers in the Miami area have received letters from the National Supplier Clearinghouse suspending their provider numbers--and many, if not all, are without appropriate cause, attorney (more...)
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Noridian "Taking Steps To Reduce Claim Inventory" - 1/16/2007
July 1 transition from Cigna (Region D contractor) results in backlog
Last week Noridian Administrative Services (NAS) posted on its website an update on the claims backlog "and also provide some background". NAS became the DME MAC for Jurisdiction D on Octob (more...)
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The New Revised CMS 1500 (08-05) Claim Form is Now Available - 1/16/2007
The new revised CMS 1500 Form, which is the 08-05 version is effective January 1, 2007, but will not be mandated for suppliers to utilize until April 2, 2007. (more...)
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FIFTH CIRCUIT HOLDS PATIENT CANNOT BRING SUIT TO ENFORCE HIPAA - 1/3/2007
“HIPAA limits enforcement to the Secretary of Health and Human Services.”
On November 13, 2006, the United States Court of Appeals for the Fifth Circuit issued a decision in Acara v. Banks, confirming that the Health Insurance Portability and Accountability Act of 19 (more...)
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Medicaid Whistle-Blower Law Goes Into Effect Jan. 1 - 12/27/2006
Health care accounts for 72% of all government fraud
Many healthcare providers will have to teach their employees how to ferret out fraud and report it to the government under a federal law that takes effect next month.
(more...)
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CMS ANNOUNCES DEEMED ACCREDITATION ORGANIZATIONS FOR SUPPLIERS OF DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS AND SUPPLIES - 11/22/2006
The Centers for Medicare & Medicaid Services (CMS) today announced the names of eleven national accreditation organizations that will accredit suppliers of durable medical equipment, prosthetics, orth (more...)
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Pride Meets with HHS Secretary Leavitt to Discuss PMD Fee Schedules - 11/15/2006
CMS to make Additional Corrections to Fees that will be Retroactive to Nov. 15
Representatives of Pride Mobility Products Corp. met Thursday with HHS Secretary Michael Leavitt and Senator Arlen Specter to discuss the PMD Fee Schedules. (more...)
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Government Data Refutes CMS Claims that Utilization of Mobility Benefit Is on the Rise - 10/27/2006
Utilization Sharply Declined Since 2003; No Support for CMS Claims of Increases
The power mobility industry said on October 26 that Medicare claims for power wheelchairs have declined significantly since reaching a peak in 2003, and that government data directly refutes the Cente (more...)
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OIG Squelches Manufacturer- Provider Partnerships - 10/17/2006
Proposed relationship poses `substantial risk`
Durable medical equipment manufacturers must be wary of partnering too closely with suppliers, says the HHS Office of Inspector General in a new advisory opinion.
(more...)
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Medicare PMC Cuts May Force Lay-Offs - 10/12/2006
Cuts of 21 Percent to 41 Percent Will Restrict Access, and Put Some Suppliers Out of Business
VGM/U.S. Rehab member Black Bear Medical, the region`s leading supplier of durable medical equipment, said today that the 21 percent to 41 percent cut in Medicare reimbursements for power wheelchairs (more...)
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Medicare Issues New Fee Schedule for Power Mobility Devices - 10/3/2006
Industry looking at a 34% cut
CMS has released the Fee Schedule amounts (ceiling and floor) for the new Power Mobility Device HCPCS Codes scheduled to take effect on November 15, 2006. (more...)
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Medicare Issues Revised Local Coverage Determinations (LCD) for Power Mobility Devices - 9/27/2006
Implementation Date of New Codes and LCD delayed until November 15, 2006
As a result of significant industry efforts to obtain modifications to the Local Coverage Determination (LCD) for Power Mobility Devices (PMDs) that was released on August 15, 2006, the Medicare Durab (more...)
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American Association for Homecare Disputes Oxygen Therapy Study by HHS - 9/25/2006
Current Medicare Oxygen Policy and Further Erosions of Benefit Put Patients at Risk
A government study about the costs of providing oxygen therapy in the home is deeply flawed according to the American Association for Homecare. Moreover, the further erosion of the oxygen benefit reco (more...)
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HIPAA Privacy Law Nets No Fines - 9/13/2006
Job of enforcement up to HHS; about 5,000 cases remain open
In the three years since Americans gained federal protection for their private medical information, the Bush administration has received thousands of complaints alleging violations but has not imposed (more...)
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Medicare To Reduce Payments to Pharmacies Compounding Inhalation Drugs - 8/28/2006
FDA previously "warned" three large pharmacies
Beginning in January 2007, CMS will make "significantly lower" Medicare payments to pharmacies that make compounded inhalation drugs for patients with respiratory needs, according to a lette (more...)
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DRA 9-Day Payment Hold - 8/25/2006
Affects all providers & suppliers who bill Medicare contractors.
A brief hold will be placed on Medicare payments for all claims during the last 9 days of the Federal fiscal year (Sept 22 through Sept 30, 2006). (more...)
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MEDICARE PROPOSED RULE REVAMPS O2 REIMBURSEMENT - 8/24/2006
CMS:“…this equates to an average reduction in (oxygen/equipment) payment…of approximately 22 percent.”
On July 27, CMS released proposed rule 1304-P, which effectively revamps the oxygen classification system by splitting stationary and portable oxygen contents into two separate payment classes. (more...)
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CMS PUBLISHES FINAL QUALITY STANDARDS - 8/22/2006
And...accreditation organization application solicitation now published
CMS has published new quality standards for suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). "Issuing these new quality standards is an important step in ou (more...)
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FINAL RULE ON ACCREDITATION OF DME SUPPLIERS RELEASED - 8/11/2006
314 page document also includes PPS rule; VGM offers "DME only" condensed version
The final rule implements requirements for DME suppliers to be accredited by independent accrediting organizations and to meet new quality standards in order to bill the Medicare program for various e (more...)
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Advance Determination of Medicare Coverage – Wheelchairs - 7/12/2006
Certificates of Medical Necessity for Manual and Power Wheelchair Bases were discontinued effective April 1, 2006
As a result, questions have arisen about what information ought to be submitted to support an ADMC request.
(more...)
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NSCAC develops format to facilitate site inspection concerns - 7/11/2006
"Tracking Form" to document events with Overland Solutions
The National Supplier Clearinghouse Advisory Committee (NSCAC) is an organization comprised of individuals that are representing their respective DMERC Advisory Committees/Councils (DAC) in all four r (more...)
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HIPAA: Changing your notice of privacy practices? - 6/1/2006
These tips will help ensure compliance!
Since the privacy rule’s compliance date, organizations have had a chance to see their programs in action. Today’s better understanding of the rule and its requirements—as well as changes in state law (more...)
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We’re fighting for a principle - 5/16/2006
and for those who can’t fight for themselves
Editor’s note: The following commentary by the president of Last Chance for Patient Choice appeared in the May issue of HME News (page 19). The points raised by Mike Mallaro are ones that need to be m (more...)
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COMPETITIVE BIDDING NPRM RELEASED BY CMS - 4/24/2006
60-day comment period -- Proposed MSA Selection Methodology Included -- "Small Business", "Opportunity To Bid Via Network" Defined & Discussed
The long awaited NPRM (Notice of Proposed Rule Making for the national competitive bidding for DMEPOS has been released. (more...)
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Information and FAQs Regarding Changes in HME Ownership - 3/15/2006
Tips from VGM and the National Supplier Clearinghouse
While there may be a variety of legal definitions and purchase options, most of the changes of ownership received by the NSC are completed using one of the following methods, which are defined as foll (more...)
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The Jersey Association of Medical Equipment Services says YES to VGM`s plan! - 3/6/2006
"We stand with VGM and urge every other state association to do the same"
The Jersey Association of Medical Equipment Services (JAMES) would like to express its enthusiastic support for VGM`s Last Chance for Patient Choice initiative. It has become clear that the HME indust (more...)
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Proposed Decision Memo For Home Oxygen Below Current Requirements - 12/27/2005
Beneficiaries must be enrolled in approved clinical trial.
CMS is seeking public comment on the agency`s proposed determination that there is sufficient evidence to conclude that the home use of oxygen is reasonable and necessary for Medicare beneficiaries wi (more...)
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OIG Review of Home Oxygen Services Survey Due November 28 - 11/22/2005
Providers Should Consider Filing 30-Day Extension
Many HME providers have contacted VGM recently with questions and concerns regarding their receipt of the "OIG Review of Services for Home Oxygen Equipment" Survey, which requests supplier i (more...)
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OIG Unveils 2006 Work Plan - 11/21/2005
Excerpts from DME, Part B Drugs- "Medical necessity", pricing, to be scrutinized
The OlG Work Plan sets forth various projects to be addressed during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Coun (more...)
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CMS: 2006 Dispensing Fees for Inhalation Therapy Drugs Drastically Reduced - 11/3/2005
"...care management activities...do not fall within the scope of a dispensing fee"
On November 2 the final rule was released that updates the Medicare Physician Fee Schedule. The final rule modified Medicare payment for dispensing fees for inhalation therapy drugs provided using ne (more...)
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Senators want delay of power wheelchair rules enactment - 10/4/2005
Grassley: "It seems as if CMS is trying to finish a puzzle with some essential pieces missing"
Three Republican senators have asked Centers for Medicare & Medicaid Services Administrator Mark B. McClellan to delay implementation of new Medicare rules for power wheelchairs. Finance Committee Cha (more...)
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CMS considering expanding coverage criteria for home oxygen - 8/29/2005
VGM members urged to comment on reconsideration of 12-year-old policy
The reconsideration will determine whether there is enough evidence to include beneficiaries with arterial oxygen partial pressure measurements in the range of 56 to 65 mm Hg. The present policy, whi (more...)
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ASCA Enforcement of Mandatory Electronic Medicare Claims Effective July 1, 2005 - 6/29/2005
"Unless you meet specific exception criteria"
CMS is reminding all providers to make sure their billing staff submits all Medicare claims electronically. However, if you believe that your facility meets one of the exception criteria, you may ne (more...)
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Region B & D FAQs: Mobility Assistive Equipment (MAE) - 6/29/2005
New national coverage determination covers medical necessity of all MAE
Q1: I heard that CMS has just released a new power wheelchair policy. Is this true?
(more...)
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DMERCs Explain Transition for Coverage of Mobility Equipment - 6/13/2005
Applies on or after May 5, 2005
Last week the DMERCs released the anticipated transition article for the new National Coverage Determination (NCD) for Mobility Assistance Equipment (MAE). The article explains the new NCD and how it (more...)
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Ten Tips for NSC Compliance - 5/25/2005
Courtesy of the Health Law Center
The NSC tells us they are here to help. But it helps them help you if you know some of their secrets. The NSC is charged with issuing provider numbers, monitoring compliance with the Supplier Standard (more...)
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As HIPAA Securty Rule Deadline Passes, Many HME Providers Not Yet Compliant - 4/21/2005
VGM offers help: complete Security Rule "Toolkit"
Is your HME or Re-hab facility ready for the HIPAA Security Rule? If not, you should consider ordering VGM`s HIPAA Security Toolkit. This complete policy and procedure manual (CD) will guide all VGM G (more...)
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HHS issues proposal on HIPAA penalties - 4/19/2005
Proposed rule has 60-day public comment period
HHS has issued for publication in the April 18 Federal Register proposed regulations establishing procedures for imposing civil monetary penalties on entities that violate the administrative simplific (more...)
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VGM Now Offers Complete HIPAA Security Rule Compliance "Toolkit" - 4/13/2005
Available now on CD; VGM Member price $100
Is your HME or Re-hab facility ready for the HIPAA Security Rule? If not, you should consider ordering VGM`s HIPAA Security Toolkit. This complete policy and procedure manual (CD) will guide all VGM G (more...)
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VGM Member Opinions Wanted: Supplier Standards - 4/11/2005
GAO requests input from industry representatives
The GAO would like your comments and opinions regarding the 21 Medicare supplier standards. (more...)
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Provider Reaction Mixed on 2005 Home Oxygen Fees - 4/8/2005
New fees implemented "as soon as possible and by no later than April 8"
Providers who had braced for big reimbursement cuts expressed quiet relief last week when Medicare announced it is reducing home oxygen fees by an average of less than 9 percent. (more...)
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Medicare's Financial Outlook Improves Slightly - 3/28/2005
Program Still Faces More Financial Problems Than Social Security, Trustees Say
Medicare`s financial outlook has "improved slightly," and its hospital trust fund will be insolvent by 2020, one year later than previously projected, according to the Medicare trustees` ann (more...)
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Simple, affordable efforts make small HME providers HIPAA Security-ready - 2/24/2005
VGM offers free and/or low cost tools for compliance
With the HIPAA security rule deadline only a few months away, you need to pick your compliance efforts up a notch. Regardless of your size, all covered entities (which includes almost all DMEPOS provi (more...)
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Analysis: Medicare fix most difficult - 2/18/2005
In hearings this week on Capitol Hill, lawmakers debate programs
All three major U.S. entitlement programs -- Social Security, Medicare and Medicaid -- are in financial trouble as the baby boomer generation heads into retirement, but fixing Medicare might be the mo (more...)
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CMS PROPOSES NEW COVERAGE CRITERIA FOR PWCs, SCOOTERS - 2/4/2005
New set of codes effective 1/1/2006
"CMS has revised the power wheelchair codes to more accurately reflect the products that are on the market today to ensure that our beneficiaries receive the product most appropriate for their co (more...)
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The NSC TOP TEN - 2/1/2005
"Reoccuring issues" that delay HME provider enrollment
The NSC has compiled a list of the top ten reoccurring issues provider enrollment analysts face when processing documentation submitted by the HME community.
These issues are a cause for unnece (more...)
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VGM Now Offers HIPAA Security Rule Compliance Tools - 2/1/2005
Most homecare providers must comply by April 21, 2005
Currently, a "HIPAA Security Toolkit for HME & Re-hab Facilities", a "Security Handbook" , and other tips are available for VGM Group members. Additional documents will be ad (more...)
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ASCA Enforcement of Mandatory Electronic Submission of Medicare Claims for DMERC - 1/25/2005
CMS reminding HME suppliers that they must submit Medicare claims electronically unless they meet specific exception criteria
HIPAA`s Administrative Simplification Compliance Act now requires you, with limited exceptions, to submit all your initial claims for reimbursement under Medicare electronically. Further, ASCA amendm (more...)
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CMS TO BEGIN PAYING OXYGEN CLAIMS - 1/14/2005
To: DMEPOS-SUPPLIERS-L@LIST.NIH.GOV
Subject: CMS Update Regarding Oxygen Payments for 2005
You were previously notified that Medicare claims for oxygen and oxygen equipment and portable oxy (more...)
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CMS releases first of seven security white papers - 12/6/2004
Papers are meant to assist providers in understanding the HIPAA security rule—not provide sure-fire compliance methods
The Centers for Medicare & Medicaid Services (CMS) released last week one of seven guidance papers on the HIPAA security rule. This paper, "Security 101 for Covered Entities," offers a basic (more...)
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GAO: Medicare payments for cancer drugs to exceed costs - 12/2/2004
Reimbursements for other services will be more than double
Medicare payments for cancer drugs will decline next year but will still exceed what doctors pay for them, congressional investigators said Wednesday.
(more...)
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CMS releases 2005 fee schedule for DMEPOS - 11/23/2004
MMA requires cuts for several popular items; oxygen rates to be posted in December
Effective January 1, 2005 CMS will reduce reimbursement by basing payment on the percentage difference between median 2002 Federal Employees Health Benefits Program (FEHBP) amounts and Medicare amoun (more...)
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Congress in February To Consider Medicare Payment Reduction - 11/16/2004
Federal budget deficit could exceed $450 billion by next year
Congress in February might begin to discuss proposals to decrease Medicare reimbursements to hospitals and other health care providers as part of an effort to reduce the federal budget deficit, Congre (more...)
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What are the implications or repercussions of a provider giving discounts on their employees' co-pays and deductibles? - 11/12/2004
Question of the week
Many healthcare facilities offer discounts to employees. Offering a discount to employees is not encouraged, but is possible. The waving or discounting of co-payments and deductibles as an employee be (more...)
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URGENT - Request For Information - 11/11/2004
Meeting with Grassley, staff re: "In the home" rule
In keeping with our commitment to provide government relations services for our members, an opportunity that has risen for us to meet with U.S. Senator Chuck Grassley (R- IA, Chairman of the Committee (more...)
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EDI Update: Maintain your ability to submit timely claims to Medicare! - 11/11/2004
New instruction issued to clarify and remind providers of existing CMS requirements and prohibitions concerning access to and use of EDI numbers and passwords
Failure to abide by Medicare security requirements for EDI access could lead to suspension of EDI capabilities. The following article clarifies and reminds providers and suppliers of existing Medicare (more...)
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Industry moves on HIPAA standards, but transition will be slow - 11/8/2004
Numerous interpretations of the guidelines make uniformity in electronic transmissions elusive, but work is under way to meet that goal -- likely still a decade away.
Healthcare providers may view the federal electronic data interchange standards as a broken promise. But private groups are working together to put the simplification back in this part of the HIPAA ad (more...)
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SADMERC Requests Timely Physician Completion of CMNs - 11/5/2004
"A message for Physicians from the (DMERC) Medical Director regarding Certificates of Medical Necessity"Stacey V. Brennan, MD, Region C medical director, released an information dispatch this week directed to all physicians to assist DMEPOS suppliers with cash flow concerns and to remind them that timel (more...)
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Program Advisory Oversight Committee Holds First Meeting - 10/14/2004
CMS lays groundwork for NCB initiative
On October 6 the Program Advisory Oversight Committee (PAOC) met in Baltimore for its initial meeting. Mandated by MMA, the committee will advise CMS on the implementation of national competitive bidd (more...)
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CMS Suggests Monthly Dispensing Fee in $55-$64 Range for Inhalation Therapy - 10/14/2004
"Gap" identified by AAH, Muse and Associates study
AAHomecare commended the Centers for Medicare and Medicaid Services (CMS) and the Government Accountability Office (GAO) for recommending adjustments to the dispensing fee for inhalation therapies use (more...)
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Consumers Voice Concern Over Unjustified Denial of Medicare Power Mobility Claims - 8/18/2004
PMC August 16 Press Release
For many years, Medicare has reimbursed 80 percent of the cost of electric wheelchairs and scooters for people with disabilities who cannot safely move about without technology to assist them. That (more...)
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VGM To Offer HIPAA Security Rule Compliance Assistance - 8/11/2004
Most homecare providers must comply by April 21, 2005
Once again, the VGM Group will offer HIPAA training to all members of VGM & Associates, U.S. Rehab, OPGA and HPC. Similar in scope to the widely popular "HIPAA Self-Assessment and Compliance Res (more...)
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CMS Publishes Discussion of New Codes For Power Wheelchairs - 8/11/2004
CMS to hold public meeting regarding codes on September 1
CMS has proposed new codes for power wheelchairs to help “more accurately reflect the actual need for and use of power wheelchairs.” Stating that the the codes are based on requirement of a “detailed (more...)
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Supplier Numbers: Hearings & Appeals Update - 8/9/2004
NSC offers options to refute denial or revocation decisions
Recently, there have been many questions regarding the Hearings & Appeals (H&A) process. As there have been some changes since the last NSC update, this article provides some details and answers to q (more...)
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Protect Patient Data With A Facility Security Plan - 7/28/2004
Providers have until April 21, 2005, to comply with the final security rule.
Mandatory compliance of the HIPAA privacy regulations, including the training requirement on your organization`s policies and procedures, took effect on April 14, 2003. However, it is now time for al (more...)
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Medicare Redefines Obesity As an Illness - 7/27/2004
DHHS' Thompson: "Treating obesity-related illnesses results in billions of dollars in health care costs"
Medicare now recognizes obesity as an illness, a change in policy that may allow millions of overweight Americans to make medical claims for treatments such as stomach surgery and diet programs.
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Commentary from VGM's Jim Walsh: CMS Gets Nasty Judicial Surprise - 7/7/2004
A Temporary Escape from Wonderland for Providers
As I sat listening to a CMS administrator at a Washington D.C. meeting last month, it occurred to me that we must be, truly, living in Alice’s Wonderland. This well dressed, articulate gentleman was (more...)
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Federal Court Upholds CMN as Medicare Document of Record - 7/6/2004
U.S. District Court Judge Lawrence Karlton Ruling Favors PWC Providers
On June 28, the Federal District Court for the Eastern District of California ruled that the Certificate of Medical Necessity (CMN) is the Medicare document of record and that the Centers for Medicare (more...)
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As of July 1, Noncompliant HIPAA Claims Subject To Payment Delay - 7/1/2004
Affects all Medicare providers, and suppliers who submit electronic claims to Medicare.
As reported by VGM last March, Medicare is modifying its Health Insurance Portability and Accountability Act (HIPAA) contingency plan. The modification continues to allow submission of non-compliant e (more...)
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DME Supplier Telemarketing Alert - 6/1/2004
Marketing company obtaining telephone lists of prospective beneficiaries
There have been recent reports of telemarketing companies making unsolicited calls to Medicare beneficiaries and asking the beneficiary about their health, any illness (es), and what type of DME equip (more...)
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Medicare Launches Chronic Care Programs - 5/12/2004
Pilot program ordered under last year's Medicare reform law
CMS will launch 10 Medicare chronic care programs by the end of the year, hoping to save money by offering hundreds of thousands of older and disabled Americans coordinated care to manage their chroni (more...)
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VGM member commentary on PWC initiatives - 5/6/2004
VGM has received several letters, faxes and emails from provider-members regarding last week’s article relative to Medicare’s “new initiatives on power wheelchair coverage and payment policy" (more...)
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CMS urges Medicare providers to understand HIPAA issues - 4/26/2004
Modified "contingency plan" will delay Medicare reimbursement
In February VGM had reported that CMS is modifying its HIPAA “contingency plan” implemented by Medicare on October 16, 2003. Specifically, CMS had announced on February 27, 2004, that Medicare would c (more...)
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TIPS ON HIPAA TRAINING - 4/23/2004
This article: Basic Requirements of the Security Rule
Mandatory compliance of the HIPAA privacy regulations, including the training requirement on your homecare organization`s policies and procedures, took effect on April 14, 2003. And organizations must (more...)
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Power Wheelchair Industry Seeks Clarity from CMS on Medicare Coverage Issues - 4/8/2004
Wants to Ensure New Policy Will Restore Coverage Benefits
On April 6 representatives of the power wheelchair industry said that questions still remain regarding the coverage policy for patients requiring power wheelchairs, even though the Centers for Medicar (more...)
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Privacy Policies Burden Business - 3/29/2004
Firms Rush To Meet Health-Privacy Mandate
Many employers don`t realize that the sweeping reforms mandated by the Health Insurance Portability and Accountability Act of 1996 apply to them.
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CMS Plans to Announce Actions to Address Power Wheelchair Concerns - 3/22/2004
Pressure from Grassley, industry factions apparently successful
In February several industry groups – including VGM – urged Sen. Chuck Grassley (R-Iowa) to pressure CMS to “preserve Medicare patients` access to necessary medical equipment, such as motorized wheelc (more...)
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Modification of CMS’ Medicare Contingency Plan for HIPAA Implementation - 3/15/2004
Providers Affected
All Medicare physicians, providers, and suppliers who submit electronic claims to Medicare.
Provider Action Needed
STOP – Impact t (more...)
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CMS Urges States To Adopt Disease Management Programs - 3/5/2004
Agency will match state costs
In A February 26 Office of Public Affairs press release, CMS urged states to adopt programs to help those with chronic illnesses better manage their diseases. In a letter to state Medicaid officials, (more...)
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HIMSS' HIPAA “Winter 2004 Survey” Indicates Many Providers, Payers Not Compliant - 2/25/2004
Less than one-half ready for standard transactions
Results are now available from the Healthcare Information and Management Systems Society (HIMSS) quarterly “Winter 2004 Survey”, approximately three months after the October 16, 2003 deadline for Tran (more...)
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Glucose Monitor Supplies: Prepay Review in Region D - 2/24/2004
Third highest ranked DME category for paid claims errors
Comprehensive Error Rate Testing (CERT) shows glucose monitor supplies to be the third highest ranked DME category for paid claims errors in DMERC Region D. Medicare contractors are required by the Ce (more...)
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Guidelines For Filing Paper Claims - 2/3/2004
Eighth in a continuing series
Failure to follow these guidelines can cause providers a delay in processing, denial of their claim, or affect payment accuracy.
The Administrative Simplification Compliance Act (ASCA) mandate (more...)
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Region B Implements Mandatory Electronic Submission of Medicare Claims as of January 20; Waiver Information Now Available - 1/20/2004
However CMS “Contingency Plan” still allows “noncompliant” electronic claims from most providers
HIPAA’s Administrative Simplification Compliance Act required all initial claims for reimbursement under Medicare, except from small providers, be submitted electronically as of October 16, 2003, with (more...)
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DMERCs Update Proof of Delivery Requirements - Revision clarifies and eases the burden of HME providers’ requirements - 1/14/2004
Seventh in a continuing series
One of the requirements for HME facilities (and all suppliers of DMEPOS) is that they must maintain a proof of delivery for all DMEPOS items provided to Medicare beneficiaries. (more...)
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Confirmation: CMS to reimburse albuterol and ipratropium at 80% AWP - 1/6/2004
Final rule of physician payment & outpatient drug reimbursement provisions of DIMA now published
Payment for most outpatient drugs will be reimbursed at 85% of the April 1, 2003 AWP, but “the Secretary retains authority to reimburse some drugs as low as 80% of AWP based on pricing information gen (more...)
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University of Pittsburgh's School of Health and Rehabilitation Sciences Letter to Dr. Hughes - 12/26/2003
Analysis and commentary re "power wheelchair policy clarification"
On December 23, 2003 the Department of Rehabilitation Science and Technology of the University of Pittsburgh’s School of Health and Rehabilitation Sciences released their interpretation and comments r (more...)
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Documentation! Tips on Orders, CMNs, DIFs, Patient Medical Records, and More - 12/17/2003
Sixth in a series
You have heard the real estate axiom, “Location! Location! Location!” In the DMERC world it is “Documentation! Documentation! Documentation!” This article will review the four types of general documen (more...)
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Power Wheelchairs and POVs – Policy Clarification and Medical Review Strategy - 12/15/2003
Fifth in a series
In a joint release by the Centers for Medicare and Medicare Services (CMS) and the Office of the Inspector General (OIG) on September 9, 2003, the Department of Health and Human Services announced a 1 (more...)
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Must my company have a Respiratory Therapist on staff if it sells oxygen? - 11/6/2003
Third in our supplier number/compliance series
In section 2B of the CMS-855S application form, there are 21 Specialty Options. All suppliers must have at least one specialty. Any given supplier may have more than one specialty. Further down, in se (more...)
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"Home Based” HME Information and Check List - 10/31/2003
Second in our supplier number/compliance series
Home-based businesses can have some unique challenges in the DMEPOS business world. The following addresses topics that the owner of a home-based business may not have considered. (more...)
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VGM provides helpful tips to reduce incidence of supplier number deactivations - 10/16/2003
First in the series: Change of Information Guide
The purpose of this Change of Information Guide is to provide helpful instructions for DMEPOS providers to submit changes of information properly and reduce the likelihood of supplier number deactivat (more...)
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Medicare Announces Plan to Accept HIPAA Non-Compliant Electronic Transactions After October 16 Compliance Deadline - 9/24/2003
Plan ensures continued processing of claims from providers who cannot meet the deadline and would have Medicare claims rejected
"Implementing this contingency plan moves us toward the dual goals of achieving HIPAA compliance while not disrupting providers` cash flow and operations, so that beneficiaries can continue to ge (more...)
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CMS Clarifies Reimbursement Rules On Power Wheelchairs - 9/19/2003
Medicare won't reimburse for POV's without written physician order
Just days after announcing a federal campaign to crack down on free power wheelchairs for beneficiaries who don`t need them, CMS issued a transmittal on September 12 stating that it will deny claims i (more...)
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HHS Announces It Will Not Extend HIPAA Electronic Claims Deadline - 9/12/2003
Payers Unprepared for October 16 Compliance Date?
On September 12 HHS announced that it will not seek to extend the Oct. 16 compliance deadline for the HIPAA transactions and code sets rule for electronically submitting health care claims, CongressDa (more...)
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CMS Announces 10 Point Power Mobility "Crackdown" - 9/9/2003
OIG Also Investigating DME Fraud
BALTIMORE 9:00 a.m. 9/9/03 - The Centers for Medicare & Medicaid Services today announced a 10-point initiative to substantially curb abuse of the Medicare program by unscrupulous providers of pow (more...)
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