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8 Feb 2019, 6:00 am
The LCDs outline the conditions under which DME MACs will pay suppliers for those braces. [read post]
28 Jun 2013, 5:15 am
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
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]
16 Oct 2009, 12:32 pm
Miss.), the Government alleged that a DME supplier set up a sham DME company that was owned by a nursing home chain, rather than the DME supplier, in order to obtain a supplier number from the Clearinghouse. [read post]
23 Apr 2012, 12:03 pm
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]
27 Jun 2012, 2:16 pm
The HHS Office of Inspector General (OIG) estimates that the four DME Medicare Administrative Contractors (DME MACs) improperly allowed a total of approximately $271 million in Medicare claims for home blood-glucose test strip and/or lancet supplies in 2007 that the OIG identified as high utilization claims. [read post]
28 Jan 2015, 12:48 pm
With the new RAC contract awarded, DME, home health and hospice providers should be prepared for increased audit activity from the new RAC. [read post]
17 Jun 2013, 3:06 pm
Wachler & Associates will continue to keep you updated on the DME CBP and other changes regarding the Medicare and Medicaid programs. [read post]
12 Nov 2006, 9:39 am
The OIG report notes that 25% of all Medicare DME expenditures are oxygen-related. [read post]
14 Nov 2012, 8:47 am
CMS has established a G-code (G0454) to provide a modest payment to the physician who documents a face-to-face encounter for the specified DME items. [read post]
10 Jun 2025, 7:29 am
Whistleblower partner Alysia Solow commented: “DME-related Medicare fraud harms all Americans. [read post]
9 Feb 2015, 5:55 am
Investigators believe that Yusuf and her co-conspirators billed Medicare for more than $3.4 million for durable medical equipment (DME) that was neither medically necessary nor prescribed by a physician. [read post]
5 Nov 2008, 7:59 am
NO-FAULT - DMEs - MEDICAL NECESSITY - FRAUDMatter of Travelers Indem. [read post]
7 Mar 2011, 2:16 am
DME INDUSTRY VOICES COMPETITIVE BIDDING CONCERNS: A bipartisan briefing was held for House of Representatives staff on March 1, in order to hear the concerns of durable medical equipment (DME) suppliers with regard to the new Medicare DME competitive bidding program. [read post]
25 Jun 2010, 12:01 pm
(June 25, 2010): The purpose of this series of articles is to assess the Recovery Audit Contractor (RAC) Program from the perspective of physicians, home health, hospice, durable medical equipment (DME) providers, and other relatively small Medicare providers. [read post]
5 Jan 2012, 2:36 pm
The contingency fee paid to a Medicare RAC is now 17.5% (up 5%) for DME claims. [read post]
31 Jul 2007, 7:45 am
This information creates the medical necessity of the DME. [read post]
20 Apr 2016, 8:21 pm
Gibran Ameer, who has worked for different DME companies, under the qui tam provisions of the False Claims Act. [read post]
14 Dec 2015, 7:22 am
DME believed that with a prescription from a physician they would be immune from prosecution but that was not the case. [read post]
