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18 Nov 2018, 8:30 pm
Self-insured employer and union sponsored health plans, health insurers and other health care payers, health care providers, managed care and practice management service providers and others structuring or working with preferred provider or other managed health care contracts should weigh the potential implications on their health plan provider agreements and managed care practices of the antitrust lawsuit jointly brought by the U.S. [read post]
12 Nov 2018, 9:53 am
There will be many things going on, such as preparing at home, the need for and type of pain medications after, and any DME that might be temporarily needed. [read post]
10 Sep 2018, 7:49 pm
House Republicans are taking action to make permanent the individual and small business tax cuts enacted under the Tax Cuts and Jobs Act (TCJA) by introducing the following three bills to accomplish Republicans’ Tax Reform 2.0 package: H.R. 6760, the Protecting Family and Small Business Tax Cuts Act of 2018, sponsored by Rep. [read post]
12 Aug 2018, 1:36 pm
The next court appearance is August 16, 2018.Attorney Commentary On This Use of Labor Code Section 139.3 As Basis for Fraud and Perjury Charges:California Labor Code Section 139.3 provides that it is unlawful for a physician to refer workers' compensation patients to a surgery center, laboratory and other services (physical therapy, diagnostic services, DME, etc.) [read post]
2 Aug 2018, 3:35 am
In the typical case, a fairer label would be “defense medical examination (“DME”).) [read post]
19 Jul 2018, 4:41 am
Pero al fin, escuchádme: todo lo que posee mi alma, todo, ¿a ver quién se atreve a medir esta hondura? [read post]
16 Jul 2018, 4:12 am
CMS also proposes: adding payment classes for portable gaseous oxygen equipment, portable liquid oxygen equipment, and high flow portable liquid oxygen contents on a budget-neutral basis; establishing payment rules for certain ventilators that also perform the function of other items of DME; and including the Northern Mariana Islands in future rounds of competitive bidding. [read post]
13 Jul 2018, 10:37 pm
A flurry of activity in the House Ways & Means Committee and other Congressional committees over the past few weeks signals the advisability of keeping a close eye on health care and health benefit reform proposals this Summer in anticipation of both the Fall health benefit enrollment and renewal season and the mid-term November Congressional elections. [read post]
31 May 2018, 9:33 am
Broadly speaking, the Anti-Kickback statute prohibits hospitals, physicians, pharmacies, nursing homes, durable medical equipment (DME) companies, pharmaceutical (drug) companies, medical device manufacturers, and other medical providers from paying or receiving kickbacks, remuneration, or anything of value in exchange for referrals of patients who will receive treatment paid for by government healthcare programs such as Medicare and Medicaid. [read post]
20 May 2018, 2:26 pm
An Overview of Administrative Rheumatology Audits / Adverse Actions AND Civil / Criminal Enforcement Actions (May 20, 2018): It’s been a rough week for at least one Texas rheumatologist. [read post]
20 May 2018, 2:26 pm
An Overview of Administrative Rheumatology Audits / Adverse Actions AND Civil / Criminal Enforcement Actions (May 20, 2018): It’s been a rough week for at least one Texas rheumatologist. [read post]
CMS Announces Temporary Fee Schedule Increase for Certain Medical Equipment Furnished in Rural Areas
11 May 2018, 1:09 pm
By way of background, the Affordable Care Act mandated that CMS use pricing information from the DME, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program (CBP) to adjust fee schedule amounts for items furnished in areas where the CBP is not implemented. [read post]
12 Apr 2018, 8:48 am
Why Was My DME Company Included in this Review? [read post]
30 Mar 2018, 1:53 pm
The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. [read post]
30 Mar 2018, 1:53 pm
The owner of a DME supply company, Tracy Browns, a co-defendant in the case, allegedly paid kickbacks to Ms. [read post]
13 Mar 2018, 6:30 am
During her tenure as chief operating officer, many new service offerings were developed, including: the BOLD® Network, a unique, state-stratified, multi-tiered approach to a preferred provider organization (PPO) strategy; a durable medical equipment (DME) formulary that applies the cost management principles of a pharmacy formulary to medical equipment; and a new chronic pain protocol, a multidisciplinary approach to addressing the complex chronic pain conditions that drive the… [read post]
16 Feb 2018, 5:39 am
An expansion of the durable medical equipment (DME) competitive bidding program to all areas of the country. [read post]
7 Feb 2018, 7:27 am
Covered DME supplies will be folded into the competitive bidding process. [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]
17 Jan 2018, 5:00 am
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]
