Medicare Compliance & Reimbursement
Share Power Mobility Denial Pain With CMS
Frustrated over inexplicable denials of power mobility claims? Don't hold it inside - the Centers for Medicare & Medicaid Services wants to hear about suppliers' troubles.
"We are continuing to ... experience absolutely horrific denials for non-ambulatory patients who are attempting at their doctor's direction to obtain power mobility," Mike Johns, director of insurance for Sewell, NJ-based Electric Mobility Corp. told CMS during the Feb. 17 Open Door Forum. EMC manufactures Rascal-brand scooters and power wheelchairs.
The problem, he said, seems particularly acute in Region B, where the durable medical equipment regional carrier is AdminaStar Federal. EMC has been challenging the denials through fair hearings and has been experiencing "a great degree of success" once an officer has an opportunity to review the specifics, Johns told the forum.
CMS has had the opportunity to take a look at "any number" of claims from Region B involving a number of different suppliers, John Warren with the CMS Program Integrity Group told listeners. "To date, we haven't found any particular instances of where Region B is reviewing claims inappropriately or denying claims inappropriately," he said.
However, Warren invited concerned suppliers to contact him to discuss problems they're experiencing with improperly denied power mobility claims. "Maybe we can figure out a plan of attack," he said.
Tip: Warren gave out his phone number in the forum: 410-786-3633.
Medicare Compliance & Reimbursement
- Health Plans:
CMS Happy With Local Medicare Plan Applications
But are regional plan numbers a bad omen for rural patients?
The Centers for Medicare and [...] - Health Spending:
Expect Scrutiny Of Health Prices As Spending Continues Upward
Growth rate is considerably higher than projected growth for the U.S. economy overall
On average, [...] - Long-Term Care:
Providers May Have To Swallow Costlier Meds In 2006
Upside: New HEDIS standards say drugs shouldn't have been included in the first place
The [...] - Legislation:
States Struggling For Ways To Cover Working Uninsured
Medicaid threatened by decline in employer coverage for lower-income workers
Even as states and the [...] - Physicians:
Chemotherapy Reimbursement Not Covering $144 Million Cost
If oncology practices feel short-changed, it may be for a reason
Chemotherapy administration payments were nearly [...] - Laboratories:
Its Time To Ramp Up Diabetes Screening Tests
Now labs can bill at least once per year for all patients
The Medicare Modernization Act [...] - DME:
Share Power Mobility Denial Pain With CMS
Region B represents a particular problem, some suppliers say
Frustrated over inexplicable denials of power mobility [...] - Home Health:
CMS Whittles Home Health Compare Measures To 10
Risk adjustment problems keep 5 NQF-endorsed standards on the sidelines.
Home health providers won't have to [...] - Enforcement:
Don't Let Networking Weave A Tangled Web
Watch for tactics that build provider alliances-but sabotage compliance
The owner of several Miami, FL durable [...] - Long-Term Care:
How CMS Plans To Make Staffing Choices Safer
OIG: Nurse aid registries are coming up short on the facts
Facilities that rely on state [...] - BILL WATCH
The following bills were introduced in the Senate: S. 437. A bill to amend titles [...]
