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8 Feb 2016, 7:35 am
CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [read post]
22 Oct 2011, 7:55 pm
Lauderdale and Miami, Florida, Robert Malove provides legal representation to doctors, medical clinics, hospitals, DME providers and other health care companies. [read post]
8 Feb 2016, 7:35 am
CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [read post]
14 Jul 2011, 12:24 pm
Of that, $95 million were either not considered medically necessary or lacked sufficient documentation to justify the claim.A whopping 78% of claims submitted by Medicare DME (durable medical equipment) providers had records that did not match physician records for medical necessity.In other words, records submitted by DME suppliers indicated the motorized wheelchair was medically necessary but the doctor records did not agree with that assessment.In most of those cases physician… [read post]
19 Jan 2012, 12:28 pm
Furthermore, as seen on the attached chart (DME data), our efforts, along with the U.S. [read post]
24 Mar 2016, 10:44 am
CMS proposes to exclude some categories of drugs, however, such as: contractor-priced drugs; influenza, pneumococcal pneumonia and hepatitis B vaccines; drugs infused with a covered item of DME (excluded during phase 1 only “so that DME policy can focus on issues related to DME and so that the model does not interfere with decisions related to the inclusion or exclusion of these drugs in DME competitive bidding”); separately billable… [read post]
15 Sep 2015, 9:14 am
Long-term care providers that bill or plan to bill for even one acute care service (like DME) will need to submit a separate re-enrollment application for each TPI through TMHP. [read post]
10 Aug 2012, 8:42 am
If you are a recipient of a CBR for SNF Billing Practices, or are among the other provider types that have been identified to receive CBRs (e.g. cardiology services, ordering DME, physical therapists, chiropractors, ambulance, hospice, podiatry, and sleep studies), please contact an experienced healthcare attorney at Wachler & Associates at 248-544-0888 to discuss evaluating the CBR analysis and development of an appropriate compliance plan that will reduce audit risks. [read post]
5 Jul 2011, 6:30 am
Obot was owner and operator of Praise DME, a durable medical equipment company that collected $945,637 in false claims. [read post]
1 Mar 2016, 7:55 am
Nursing facility providers must continue to bill all other PASRR durable medical equipment (DME) using the existing billing information provided below. [read post]
2 Feb 2018, 2:51 pm
The amendment to §19.2703 adds new definitions for CMWC, DME, HHSC, and therapy services. [read post]
26 Sep 2016, 8:18 am
Following another Defense Medical Examination (DME, laughingly referred to officially as an “Independent” Medical Examination, where nothing is independent) with the same expert as in the prior litigation, the workers’ compensation insurance carrier filed another Petition for Termination in 2010. [read post]
16 Oct 2019, 6:47 am
He covered seven important aspects litigators can follow if they have a truck collision client with a brain injury: Getting Before and After WitnessesAlteration of Consciousness WitnessesBuild Up Your Clients Pre-Morbid IntelligenceDocument and Record ComplaintsIsolate the Defense Medical Examinations (DME)NeuroimagingAttack the Malingering Tests ThemselvesTo read Attorney Abraham’s full analysis, you can contact him directly here or you can subscribe online at AAJ’s trucking… [read post]
22 Feb 2011, 8:50 am
The obvious answer is, "'I have no idea," but so many of the DME docs just feel compelled to go all the way in to fight anything they perceive as progress for a plaintiff's lawyer. [read post]
14 Sep 2015, 9:09 am
Long-term care providers that bill or plan to bill for even one acute care service (like DME) will need to submit a separate re-enrollment application for each TPI through TMHP. [read post]
24 Aug 2009, 8:57 pm
This article is about a criminal prosecution brought by the California AG over $678,000 in DME fraud. [read post]
22 Jul 2009, 5:00 am
In addition, with Miami 's immigrant community in mind, the legislature also now requires a $500,000 bond to be posted for any new or change of ownership for health care clinics, DME and home health providers. [read post]
26 Sep 2016, 8:18 am
Following another Defense Medical Examination (DME, laughingly referred to officially as an “Independent” Medical Examination, where nothing is independent) with the same expert as in the prior litigation, the workers’ compensation insurance carrier filed another Petition for Termination in 2010. [read post]
14 May 2012, 5:05 am
” At the hearing, the GAO issued a report reiterating its recommendations to minimize improper Medicare payments (such as using prepayment controls to identify potentially-improper DME claims and enhanced payment safeguards for physicians who use advanced imaging services) and improve oversight of Medicaid payments. [read post]
27 Apr 2009, 10:00 pm
In a move targeted to increase health care fraud enforcement by the State of Florida, the Florida legislature has recently passed legislation containing a number of new fraud provisions, including: * elevating Medicaid fraud from a third degree felony to first, second and third degree felonies based upon dollar amounts of fraud and increasing fines to five times the amount of the fraud; * designating Miami-Dade County as a "health care fraud crisis area" and increasing the monitoring of… [read post]
