The FBI & DOJ targeted alleged schemes involving the payment of illegal kickbacks and bribes by DME companies in exchange for the referral of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces that were medically unnecessary. Some of the defendants allegedly controlled an international telemarketing network that lured over hundreds of thousands of elderly and/or disabled patients into a criminal scheme that crossed borders, involving call centers in the Philippines and throughout Latin America.
Budget neutrality dampens certain oxygen reimbursement | HME News
“These additional cuts for home oxygen therapy are certain to impact providers and patients in rural and other non-CBA areas,” stated AAHomecare in a bulletin. “Since CMS has repeatedly made it clear that they do not believe they have the statutory authority to address the budget neutrality offset, the HME community needs to make this a priority for advocacy efforts in the 116th Congress.”
“The purpose of the retail awards competition is to promote and recognize products that contribute to providers’ bottom lines though cash sales. Representatives from seven companies made their case to session attendees, who along with judges, voted on their top three choices.”
“Amazon is striving to make the patient’s access to medical supplies easier and comfortable with the help of this project. Notably, this project will allow the doctors to prescribe medical products necessary for their patients after a surgery or in general cases through the hospital’s online portal.”
“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.”
“Another data point shows just how greatly Medicare’s importance as a revenue driver for HME has dropped. In addition to Medicare’s 16 percent share, Medicaid accounted for 15 percent of HME spending, and all other sources, such as private payer and retail sales, represented 68 percent of HME spending.”
“According to research AAHomecare had been performing using Medicare data, the number of traditional suppliers of home medical equipment to Medicare beneficiaries has dropped 40.9 percent since July 2013. In addition, the number of unique locations (commonly referred to as rooftops) serving Medicare beneficiaries has declined by 38.7 percent during the same period.”