New Tools to Fight Fraud, Strengthen Medicare and Protect Taxpayer Dollars

The Affordable Care Act improves and expands consumer protections, strengthens Medicare, Medicaid and the Children’s Health Insurance Program (CHIP), and reduces health care costs. One important way it achieves these goals is by improving government-wide efforts to fight fraud, waste and abuse. The new law contains some critical new tools to improve and enhance the [...]

DJO Orthotic Fitter Course

DJO is proud to announce the 2010 dates for the DJO: Orthotic Fitter Course.  This course is an ABC and BOC approved entry-level educational course for any practitioner wishing to become a Certified Orthotic Fitter (COF).  This course provides a wonderful balance between lecture and laboratory experiences.  Anatomy, physiology of injury, and symptoms requiring brace [...]

DJO Incorporated Celebrates Production of its One Millionth DonJoy Defiance Knee Ligament Brace

DJO Incorporated, a global provider of medical device solutions for musculoskeletal health, vascular health and pain management, today announced that its Bracing and Supports group manufactured their milestone one millionth DonJoy® Defiance® knee brace. Please click here for the entire press release DEFIANCE

PECOS Enrollment Delayed Until January 3, 2011

The delay in implementing Phase 2 will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation. [...]

The National Provider Identifier (NPI) – What You Need to Know

This booklet was created to help you become more familiar with the National Provider Identifier (NPI). The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of a standard, unique health identifier for each health care provider. The NPI Final Rule, published on January 23, 2004, established [...]

Update on Elastic Spinal Garments

Effective for claims with dates of service on or after April 1, 2009, if a spinal garment billed with one of the preceding HCPCS codes is made primarily of elastic material, the supplier must add the GY modifier to the code and the claim line will be denied as noncovered, no benefit category. If a [...]

Compliance Standards for Consignment Closets and Stock and Bill Arrangements

Transmittal 300, dated September 1, 2009 is being rescinded. CMS is rescinding this change request to consider other implementation dates.   Please click here to see document Transmittal 300

The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) February 17, 2010

During this call, CMS staff will discuss: • Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for physicians, non-physician practitioners and provider and supplier organizations • Provider and supplier reporting responsibilities • Medicare ordering and referring Issues • Revalidation efforts For more information please click here  CMS Open Door Forum

MEDICARE ORDERING AND REFERRAL FILE

As stated in the CMS provider listserv messages that were sent last fall concerning CRs 6417 and 6421, CMS has made available in the Downloads section of this web site a file that contains the National Provider Identifier (NPI) and the name (last name, first name) of all physicians and non-physician practitioners who are of [...]

A Message of Interest to Physicians and Non-Physician Practitioners Regarding NPI and Enrollment Files

Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) [...]

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