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29 Jul 2013, 10:21 am by Debra A. McCurdy
In addition to ESRD policy changes, the proposed rule addresses Medicare coverage of and payment for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), including the definition of routinely purchased DME; the three-year Minimum Lifetime Requirement; and fee schedules for splints, casts, and intraocular lens (IOLs) inserted in a physician’s office. [read post]
25 Feb 2015, 1:52 pm by Debra A. McCurdy
Note that CMS announced on February 25, 2015 that Medicare FFS providers, clearinghouses, and billing agencies successfully participated in the first successful ICD-10 end-to-end testing week (from January 26 through February 3, 2015) with all Medicare Administrative Contractors (MACs) and the Durable Medical Equipment (DME) MAC Common Electronic Data Interchange (CEDI) contractor. [read post]
16 Sep 2013, 2:30 pm by Debra A. McCurdy
Two recent OIG reports point out the savings that state Medicaid programs could attain if they based reimbursement for DME, prosthetics, orthotics, and supplies (DMEPOS) on Medicare competitive bidding payment amounts – although at least one state is pushing back on this idea. [read post]
9 Apr 2014, 7:07 am by Debra A. McCurdy
The files include data on services furnished by physicians, non-physician practitioners, laboratories, imaging, and ambulances, but not durable medical equipment (DME). [read post]
13 Mar 2013, 10:25 am by Debra A. McCurdy
Recent OIG reports address DME infusion drugs, long-term care hospital reporting of co-location status, conflict-of-interest oversight for Medicare Part D pharmacy and therapeutics committees, Part B drug pricing, and skilled nursing facility care planning/discharge planning. [read post]
25 Jul 2014, 11:51 am by Debra A. McCurdy
Finally, the proposed rule would make significant changes to Medicare reimbursement policy for DME, prosthetics, orthotics, and supplies (DMEPOS). [read post]
28 Apr 2016, 1:40 pm
"By contrast, here's Judge Paez's take:"In my view, DME suppliers do not exercise substantial professional or managerial discretion within Medicare’s reimbursement scheme because Medicare’s rules and regulations confine them to a ministerial role and leave all critical determinations of medical need to the beneficiary’s physician. [read post]
29 Sep 2012, 7:20 pm
(AP - Karen Rayburn, a 47-year-old Baton Rouge woman, who worked as a patient recruiter for several Louisiana durable medical equipment (DME) companies has been sentenced to 18 months in prison for her role in a Medicare fraud scheme. [read post]
15 Jan 2009, 12:09 am
., decided 1/9/2009)Appeal from a Queens Civil judgment for plaintiff DME provider on its motion for summary judgment.REVERSED and State Farm's cross motion for summary judgment was granted. [read post]
11 Aug 2021, 12:18 pm by jeffreynewmanadmin
According to allegations in the superseding indictment, Harry and his co-conspirators solicited illegal kickbacks and bribes from durable medical equipment (DME) suppliers and marketers in exchange for orders for DME braces and medications. [read post]
6 Jul 2012, 1:02 pm by Tom Lamb
  From that 2012 medical journal article about Avandia and Actos being associated with diabetic macular edema (DME) eye disease: In conclusion, this large-population study has shown that, even after adjustment for a range of confounding variables, thiazolidinediones [(TZD) diabetes drugs, such as Actos and Avandia] are associated with an increased risk of DME in patients with type 2 diabetes, especially those undergoing insulin therapy. [read post]
21 Feb 2025, 7:42 am by jeffreynewmanadmin
The DME suppliers and pharmacies that paid illegal kickbacks in exchange for these doctors’ orders generated through DMERx billed Medicare and other insurers more than $1 billion. [read post]
30 Mar 2018, 1:53 pm by Kevin S. Little
  The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. [read post]
4 May 2009, 9:08 am
If the court orders that the financial records be produced, usually that is the last you see of the DME doctor. [read post]
15 Aug 2024, 1:21 pm by Sadie Mayhew
Spellman and his co-conspirators ran Dimon Business Solution, a company that posed as a legitimate durable medical equipment (DME) management business. [read post]
30 Mar 2018, 1:53 pm by Kevin S. Little
  The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. [read post]
8 Jul 2010, 8:51 am by Lisa Baird
 In this analysis, we concentrate on those provisions in the new law that will affect suppliers and manufacturers of durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS). [read post]
3 Jun 2008, 11:57 am
Or would he have concluded that the receipt of each "claim" -- such as All-Boro's DME bill -- is what triggers the 30-day EUO scheduling requirement? [read post]
16 Jul 2010, 4:53 am by Ben Vernia
These fraud schemes involved false billing for physical and occupational therapy and DME. [read post]