Category: Medicare

Reminder: Start Using the Revised CMS-855S Enrollment Application

Posted on by DME INFO

DMEPOS suppliers are reminded that the CMS-855S enrollment application was recently revised to capture additional information pertinent for enrollment processing. Suppliers should use the CMS-855S version (07/11) if enrolling in Medicare for the first time, reporting changes to existing enrollment, if you have been asked to revalidate your existing enrollment, and other limited circumstances.

The 07/09 version of the CMS-855S will only be accepted through December 31, 2011. Any information received on the obsolete form after this point will be returned to the supplier resulting in a delay to your enrollment activities.

Download and begin using the revised version today by accessing the forms by clicking here:  CMS Forms

2012 DMEPOS FEE SCHEDULE

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2012 DMEPOS FEE SCHEDULE

The DMEPOS fee schedules are updated on an annual basis in accordance with statute and regulations. The update process for the DMEPOS fee schedule is located in Pub.100-04, Medicare Claims Processing Manual, chapter 23, section 60B. Policy: This recurring update notification provides instructions regarding the 2012 annual update for the DMEPOS fee schedule. Payment on a fee schedule basis is required for durable medical equipment (DME), prosthetic devices, orthotics, prosthetics, and surgical dressings by §1834(a), (h), and (i) of the Social Security Act.   Please click here for 2012 Fee Schedule.

2010 Recovery Audit Program Results

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FY 2010 was the first year in which the Recovery Auditors (RAC) began actively identifying and correcting

improper payments under the National Recovery Audit program. All the Recovery Auditors began

reviewing claims in October 2009. In the past fiscal year, the Recovery Auditors identified and corrected

$92.3 million in combined overpayments and underpayments. Eighty-two percent of all Recovery Audit

program corrections were collected overpayments, and 18 percent were identified underpayments that

were refunded to providers. $18.8 million in Medicare overpayments  were collected for durable medical equipment.

For more information, please click here for the entire report  RAC REPORT

NEXT STEPS FOR EXPANSION OF THE MEDICARE DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND SUPPLIES COMPETITIVE BIDDING PROGRAM

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The Centers for Medicare & Medicaid Services (CMS) today announced plans to expand the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. This program is an essential tool to help Medicare set appropriate payment rates for DMEPOS items and services. Except in nine areas of the country where the program is now in effect for certain items, Medicare pays for DMEPOS items using a fee schedule that is generally based on historic supplier charges from the 1980s, increased by an annual covered item update factor. Numerous studies from the Department of Health and Human Services Office of Inspector General and the Government Accountability Office have shown that the fee schedule amounts for certain DMEPOS items are excessive; taxpayers and Medicare beneficiaries bear the burden of these excessive payments.

Please click here to read the entire CMS Press Release.

Please click here to read the list of devices and HCPCS Codes announced for Round II Competitive Bidding.

View the HEAT Provider Compliance Training Webcast

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Hear from the Office of Inspector General and other government experts as they educate local health care providers, compliance officers, and their legal counsel about the realities of Medicare fraud and the importance of implementing an effective compliance program.

  • Get the Facts. Understand the law and the consequences of violating it.
  • Make a Plan. Cultivate a culture of compliance within your health care organization.
  • Know Where to Go. Learn what to do when a compliance issue arises.

This free compliance training is offered by the U.S. Department of Health and Human Services, Office of Inspector General. No registration is required to view this event.  Please follow this link for more information HEAT