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11 Oct 2012, 6:51 am
DME suppliers should also be aware of other issues that appear in the Work Plan. [read post]
29 Aug 2013, 8:19 am
Emanuel was a DME supply company that sold, among other things, power wheelchairs and related supplies. [read post]
8 Jun 2010, 11:35 am
Effective July 6, 2010, physicians who have not enrolled in PECOS or opted out of Medicare will not be able to order or refer Medicare patients for home health services or DME. [read post]
8 Jun 2010, 11:35 am
Effective July 6, 2010, physicians who have not enrolled in PECOS or opted out of Medicare will not be able to order or refer Medicare patients for home health services or DME. [read post]
15 Dec 2023, 6:56 am by Cynthia Marcotte Stamer
A Texas man could serve more than 20 years in prison if convicted of health care fraud for his alleged role in a $60 million health care fraud, wire fraud, and kickback scheme involving the submission of false and fraudulent claims to Medicare for medically unnecessary durable medical equipment (DME), genetic tests, and foot bath […] [read post]
19 Jul 2012, 1:44 pm by Debra A. McCurdy
CMS also is proposing the use of a G-code, with an estimated rate of $15, to compensate a physician who documents a face-to-face encounter for the specified DME items. [read post]
3 Jul 2010, 10:35 am by Carol L. Schlitt
If you file a negligence lawsuit in New York State, the defense is entitled to request a Defendant’s Medical Exam (DME). [read post]
19 Mar 2014, 8:06 am by Debra A. McCurdy
The four Durable Medical Equipment (DME) Medicare Administrative Contractor (DME MAC) medical directors have issued a joint open letter to physicians warning about “various marketing schemes” perpetrated by DME suppliers. [read post]
17 Jan 2018, 5:00 am by Debra A. McCurdy
Under any of these methods, if a state discovers that its payments for relevant DME items exceed the FFP limit, CMS directs that the overpayment must be returned to CMS. [read post]
30 Jun 2012, 2:49 pm by Cynthia Marcotte Stamer
A Baton Rouge, Louisiana judge is sending two area women to jail for their participation in a durable medical equipment (DME) health care fraud scheme. [read post]
18 Aug 2009, 7:05 am
In general, Stark prohibits physicians from "self-referring" for "designated health services," which include DME. [read post]
10 Sep 2013, 8:09 am by Debra A. McCurdy
By way of background, under CMS rules implementing section 6407 of the ACA, as a condition of payment for specified items of DME, a physician must have documented and communicated to the DME supplier that the physician or a physician assistant, a nurse practitioner, or a clinical nurse specialist has had a face-to-face encounter with the beneficiary within the six month period before the written order. [read post]
24 Jun 2015, 11:21 am by Debra A. McCurdy
CMS is proposing to revise the coding used to describe miscellaneous durable medical equipment (DME). [read post]
13 Mar 2013, 12:25 am by Debra A. McCurdy
The OIG recommends that CMS either (1) seek legislation requiring DME infusion drug payment to be based on ASP, or (2) include DME infusion drugs in the next round of the DMEPOS competitive bidding program. [read post]
24 Apr 2013, 1:48 pm
The new RAC contract period will run through 2018, and we suggest that all Medicare and Medicaid providers read through the modified RAC Statement of Work and also the new Statement of Work for DME, home health and hospice recovery auditors. [read post]
8 Feb 2019, 6:00 am by Lorraine Rosado
The LCDs outline the conditions under which DME MACs will pay suppliers for those braces. [read post]
28 Jun 2013, 5:15 am by Debra A. McCurdy
CMS intends to “start actively enforcing and will expect full compliance with the DME face-to-face requirements beginning on October 1, 2013. [read post]
11 Jan 2009, 11:58 pm
(Emphasis added.)Plaintiff DME provider sued to recover $317 in unpaid bills and moved for summary judgment. [read post]
1 Nov 2011, 7:54 am by emagraken
While Plaintiff’s in personal injury lawsuits sometimes have to be subjected to multiple defence medical exams (DME) one well-settled principle is that subsequent exams to bolster a previous defence opinion are not permitted. [read post]
23 Apr 2012, 12:03 pm by Debra A. McCurdy
CMS also acknowledges that certain categories of DME include items that are not interchangeable; the agency will determine annually which categories or subcategories of DME require full plan coverage without limitation by brand or manufacturer. [read post]