OIG to CMS: Take stronger look at ‘place-of-service’ claims | HME News

“The report found:  For 72% of inappropriate claims, DME suppliers failed to correctly code the SNF as a facility. Instead, they coded the place of service as the beneficiary’s home, thus enabling the claims to bypass the edit that rejects separate payment for most DME provided at facilities. By definition, SNFs provide primarily skilled care and thus cannot be considered beneficiary homes.”

Read the full source article: OIG to CMS: Take stronger look at ‘place-of-service’ claims | HME News

Read the OIG report:  CMS Did Not Detect Some Inappropriate Claims for Durable Medical Equipment in Nursing Facilities


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Home medical equipment industry jeopardized by low reimbursement rates, study says

“Medicare reimbursement rates for home medical equipment cover just 88 percent of overall costs for companies providing this service, raising concerns about the future viability of the home medical equipment industry under the current Medicare model, according to an American Association for Homecare study.

The report’s conclusions show the current Medicare competitive bidding program for home medical equipment is producing financially unsustainable rates, and faults the program for its lack of transparency.”

Read the full article: Source: Home medical equipment industry jeopardized by low reimbursement rates, study says


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