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19 May 2019, 2:30 pm
In parallel with the Department’s criminal actions, the Center for Medicare Services, Center for Program Integrity (CMS/CPI) simultaneously took adverse administrative action against 130 DME companies that had submitted over $1.7 billion in claims and were paid over $900 million. [read post]
6 May 2019, 5:44 pm
Health plans, their sponsoring employers and unions, insurers, fiduciaries, administrators, insurers and other service providers should learn from the $3 million lesson a Franklin, Tennessee-based diagnostic medical imaging services provider is learning about the heavy penalties a health plan, health care provider, health care clearinghouse or business associate (“Covered Entity”) risks if a post-data breach investigation by the U.S. [read post]
30 Apr 2019, 11:15 am
which included C-level executives allegedly accepting illegal kickbacks and bribes from DME companies. [read post]
30 Apr 2019, 10:23 am
Health plans must deliver electronic protected health information (“ePHI”) to electronic applications or software (“apps”) used by plan members, and are responsible under the Health Insurance Portability & Accountability Act (“HIPAA”) Privacy and Security Rules for the security of electronic protected health information (“ePHI”) on apps they sponsor or provide, according to new guidance from the Department of Health & Human Services… [read post]
23 Apr 2019, 2:28 pm
The Centers for Medicare & Medicaid Services (CMS) is expanding the types of durable medical equipment (DME), prosthetic, orthotics, supplies (DMEPOS) that are subject to Medicare prior authorization requirements on the basis of being “frequently subject to unnecessary utilization. [read post]
11 Apr 2019, 2:17 pm
Suspects in the case include executives at five telemedicine companies, the owners of dozens of durable medical equipment (DME) companies and three licensed medical professionals. [read post]
10 Apr 2019, 5:48 am
The individuals charged include three licensed professionals, CEOs and COOs of telemedicine companies, and the owners of dozens of DME companies. [read post]
9 Apr 2019, 5:59 pm
On April 9. 2019,, the Department of Justice announced healthcare fraud arrests of 24 individuals, including doctors and executives at telemedicine and durable medical equipment (DME) companies. [read post]
28 Mar 2019, 12:20 pm
If that issue arises, the DMV may contact you and ask you to complete a “Form DS 326,” also known as a Driver Medical Evaluation form, or DME. [read post]
26 Mar 2019, 1:34 pm
Establishing a demonstration to test the use of a benefits manager for serial/refill DME claims. [read post]
14 Mar 2019, 11:43 am
Also, while DME can be an appealing investment, there are significant regulatory compliance issues to understand with regards to DME relationships. 2. [read post]
13 Mar 2019, 3:30 am
A budget summary explains that DME suppliers currently “can submit very low bids during the competition to win a Medicare contract and still get paid a higher price even though their low bid reduced prices for all other suppliers in the competition area. [read post]
8 Feb 2019, 6:00 am
The LCDs outline the conditions under which DME MACs will pay suppliers for those braces. [read post]
8 Feb 2019, 6:00 am
The LCDs outline the conditions under which DME MACs will pay suppliers for those braces. [read post]
7 Feb 2019, 3:03 pm
Health plans and their employer and other sponsors, fiduciaries, administrators and other service providers, as well as health care providers, health care clearinghouses and their business associates (“Covered Entities”) should reconfirm the adequacy of their Health Insurance Portability and Accountability Act (“HIPAA”) compliance and risk management in light the U.S Department of Health and Human Services Office of Civil Rights (“OCR”) February 7, 2019… [read post]
5 Feb 2019, 6:30 am
An expert on durable medical equipment (DME) should be involved in the settlement process to provide expertise on when, where and how much money will be needed. [read post]
8 Jan 2019, 12:38 pm
Interoperability will be a key priority for the Office of the National Coordinator for Health Information Technology (“ONC”) going forward. [read post]
20 Dec 2018, 6:30 am
A pre-arranged pricing agreement for the DME items listed above will reduce the cost of DME. [read post]
15 Dec 2018, 7:41 am
A ruling by a Federal District judge on Friday (December 14, 2018) ruled unconstitutional the Patient Protection and Affordable Care Act (ACA) touches off a new wave of uncertainty about the future of the massive healthcare reform law commonly known as Obamacare just as the enrollment period for 2019 health coverage ended. [read post]
13 Dec 2018, 12:15 pm
February 12, 2019 is the deadline for health plans and their sponsoring employers, fiduciaries and business associates, as well as health care providers, health care clearinghouses, health care consumers, employer and other concerned persons to provide input on reducing the regulatory burdens of the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security and Breach Notification Rules in response to the December 12, 2018 invitation of the U.S. [read post]
