Best Practices for Securing a Favorable CPAP Audit Outcome
February 3, 2015 at 11:00am ET Presented by Andrea Stark, Reimbursement Consultant with MiraVista, LLC
The E0601 is under prepayment review for all four DME MACs and review results continue to show high error rates. This means that PAP providers across the country are feeling the pressure with strained reimbursement for this category. Join this event as Andrea highlights the vulnerabilities identified in timely reviews and aids providers in developing best practices to prevent denials and appeals progression.
NCAMES 2015 Winter Meeting to be held February 11-12th at the Sheraton Raleigh Hotel has a packed agenda FULL of presentations and education relating to "Breaking Bad Habits for Happy Days” in our industry. Don’t miss this two-day meeting that will address topics such as: "HME 2015 & 2016 Get Smart With a Two Year Prognosis", "NCGA Update, 2015: What's Happening with Audits", Medicare, Medicaid, NC Tracks and Updates from Washington on both the Political and the Regulatory side. Special invited guests include Members from the NCGA, and Acting State Health Director, Dr. Robin Cummings. Sign up today!
These pocket-sized booklets feature the current Medicare LDC (Local Coverage Determination) for the most commonly prescribed DME items. Use them as marketing tools and educational items for your prescribers and your referral sources. Make sure that your customer service and billing staff have the current guidelines in hand to ensure that your business is providing equipment to beneficiaries that always meets Medicare requirements.
(Dunn, NC) – Congresswoman Renee Ellmers (R-NC) attended a meeting with North Carolina medical equipment suppliers who are members of NCAMES (North Carolina Association for Medical Equipment Services) on Tuesday October 7 at Family Medical Supply headquarters in Dunn, NC. Representatives from Brightree, MiraVISTA, MedGroup and VGM also joined the group.
The discussion at the meeting centered around the effects of Medicare policies like competitive bidding and the audit and appeals on medical equipment suppliers and Medicare beneficiaries in North Carolina and around the country. Ellmers said, “the longer we can keep patients in the home and healthy, the better for saving Medicare dollars and the better for the patients overall well-being.”
NCAMES Summer Meeting
NCAMES is grateful for Congresswoman Ellmers' continued support and efforts to bring attention to the devastating effects of the audit burden. Please watch the video below of our Champion's questioning CMS regarding RAC and MAC audits.
NCAMES was honored to have Congresswoman Ellmers as our guest at the NCAMES Summer Meeting.
FOR IMMEDIATE RELEASE
June 25, 2014
CONTACT: Press Office
Medicare Program Official Confirms that Administration Failed to Meet Its Key Goals to Reduce Waste, Fraud, and Abuse
Oversight and Investigations Subcommittee Members Discuss Lost Opportunities to Eliminate Waste, Fraud, Abuse and Strengthen Medicare
WASHINGTON, DC – The House Energy and Commerce Subcommittee on Oversight and Investigations, chaired by Rep. Tim Murphy (R-PA), today held a hearing, “Medicare Program Integrity: Screening Out Errors, Fraud, and Abuse,” to discuss what steps need to be taken to eliminate the waste of tens of billions of taxpayer dollars and strengthen the Medicare program. Members heard testimony from administration officials from the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services Office of Inspector General (HHS OIG), and the Government Accountability Office (GAO).
During questioning, Deputy Administrator and Director at the Center for Program Integrity at CMS, Shantanu Agrawal, M.D., admitted to Murphy that the administration has failed to meet its target goal of a reduced improper payment rate for Medicare fee-for-service and that the improper payment rate had actually worsened over the last fiscal year.
Rep. Renee Ellmers (R-NC) underscored the problems with the systems currently in place to audit certain providers. “There is fraud, we all know that there is fraud and abuse of the system, but you are going after the good guys to make up the dollar difference. You are not addressing the real fraud issues. You are not taking recommendations and applying them, your own recommendations.”
WRAL-TV invites NCAMES as a Guest of
"On the Record" Show
Airs Saturday, Oct 12th at 7:30 pm
David Crabtree, anchor with WRAL-TV, goes behind the headlines for a more in-depth discussion of the issues - current topics, political discussions and news events every Saturday at 7:30 p.m. on WRAL-TV.
NCAMES' Members were guests on the program and spoke to the concerns with the NC Tracks Medicaid billing system. Ed Dressen, owner of Dressen Medical in Holly Springs and NCAMES president sat along side Mel Elliott, VP of NuMotion in Apex as they discussed cash flow problems, patient access and related issues with Crabtree. (photo attached) Dressen and Elliott followed NC State Auditor Beth Wood as she spoke to the results of an audit done by her office regarding the implementation date of the CSC system as it came after the old HP legacy system. (more info below)
Those of you in the Raleigh area can set your DVRs to tape the program (keep in mind, college football may preempt the program) but you can visit this site for a recording of the show that goes online by 2pm Saturday.
More info: Wood pointed to her office's May 22 audit of the new billing system, which warned that NCTracks had serious flaws and that DHHS should re-evaluate its decision to go live on July 1. Wood wrote that she met with Wos in March to talk about her concerns with the system. Also on Tuesday, DHHS Chief Information Officer Joe Cooper told lawmakers that testing done by DHHS and technology contractor CSC in advance of the go-live date indicated that the system had met all benchmarks. The May audit, however, warned that there were several shortcomings in the testing of the system. The audit found that out of 834 "critical" priority tests scheduled, NCTracks failed 123 tests and that 285 other critical test cases were not performed. Link to the full article - Click Here
They need to understand the SEVERITY of the issue rather than the thought that NC Tracks is operating as it should.
NCAMES Lobbied in DC to Save Patient Access
NCAMES Members lobbied DC this week to Save Patient Access, Business and Jobs but asking for DMEPOS Bidding to be STOPPED. Their message was passionate and clear…”we cannot survive with 45% and 72% cuts to the already deep cuts these last few years. Massive job loss and business closures will occur unless you stop this” The message has been heard and things are happening…stay tuned! Continue to call Congress with the same message – 202-224-3121.
Save Patient Access!
ALL HANDS ON DECK!
4 Easy Steps to Inform Congress
Step 1: Call your member of Congress
Call the U.S. Capitol Switchboard at 202-224-3121 and join in the efforts of expressing your frustration about the current bidding program. NC Representatives and Senator's office numbers are listed below. If you do not know who your representative is, call the U.S. Capitol Switchboard and give your zip code to be transferred to your representative.
We are at that point where attention and support from legislators is critical in working to replace this flawed system. As an industry we need everyone's help! Even if you are not able to make the trip to DC, the same impact can be delivered through a passionate phone call. Mark your calendars and get your dialing fingers ready to call your legislator February 26-27!
Below is a sample script to use at your convenience. If you have any personal stories about how your business is concerned about their future and the patients they serve due to the release of Round 2 prices please share them with your legislator.
"My name is ______(your name)_______ and I'm from _______(your hometown). I own/work for _______(your company). Some of my fellow industry stakeholders are currently in DC speaking with their members of Congress about the faulty competitive bidding system. In conjunction with their efforts, I am calling to insist that Rep./Sen. _____(name) work to stop the current bidding program. This process encourages unethical manipulation of the bidding system by submitting a "low ball" bid in order to increase the probability of being awarded a contract. CMS has continued to deny industry and congressional requests for information pertaining to the methodology and specific factors used not only for Round 2, but for the Round 1 rebid which has been in place for over two years! Over 200 economists and auction experts agree the current system is flawed, and as an industry we have a solution. The Market Pricing Program (MPP) would address all of the critical problems while still setting fair market prices. I am requesting that Rep./Sen. _____(name) contact their respective leadership in the House and Senate and tell them that this program will hurt beneficiaries and providers and it needs to be stopped. Thank you."
Step 2: Tell others to "Shutdown the Switchboard"
Reach out to employees, referral sources, patients, caregivers, and competitors and urge them to call their member of Congress at 202-224-3121. Also, forward them the petition to and ask to add their name along with yours.
Step 3: Sign petition to repeal bidding program
A New York Medical Equipment Providers Association (NYMEP) member developed a petition to repeal the bidding program on the White House's website. 100,000 signatures are needed before the White House looks at the request to repeal the bidding program. Please pass this message to other industry stakeholders.
Step 4: Get your beneficiaries involved
The People for Quality Care has a brochure that explains the Medicare competitive bidding program in simple terms for beneficiaries. Whether you display them on the front cover or give them to customers during deliveries, it will help to educate beneficiaries about the situation and encourage them to speak out to Congress. The best part is they are free to you! Click here to be directed to the brochure. Or, you can contact Beth Cox at firstname.lastname@example.org or 866-544-7913 with your address and the quantity you need, and VGM will send them directly to you.
CMS Competitive Bidding Program Demands Attention
NCAMES Featured in NC Spin's Opinion Editorial
Opinions surrounding Medicaid expansion and the implementation of the state’s Health Insurance Exchange are garnering a lot of attention, as well they should. Unfortunately, the same can’t be said for the Centers for Medicare and Medicaid Services (CMS) recently enacted and soon to expand competitive bidding program for certain durable medical equipment and services. Click here for the rest of the article.
Medicare Audits and Competitive Bidding
A Beneficiary Speaks Out
Triangle Home Medical Equipment Providers Rally for Jobs During President Obama Visit
Expansion of Disastrous Medicare Bidding System Costing Jobs, Threatening Patient Care
Dozens of stakeholders from the Triangle’s home medical equipment (HME) industry grabbed homemade signs and rallied for jobs around the corner from where President Obama touted his jobs bill at a local business that outsources jobs to Costa Rica.
Organized by the North Carolina Association for Medical Equipment Services (NCAMES), the rally was designed to bring attention to Obama administration policies decimating home medical equipment providers and their employees, such as expansion of the disastrous Medicare bidding system for HME providers.