Important News from CMS

• NSC Updates: Introducing the PTAN
  Also: The DMEPOS Enrollment Process v. The Accreditation Process
• CMS Sets August 31st as Accreditation Deadline for NCB
• NPI “Contingency Plan” Announced
• CMS Policy Revision on Nebulizers
  MESA Memo
• CMS Developing Competitive Bidding Implementation Website
  Multi-purpose site designed for suppliers, referral sources, beneficiaries
• CMS Requests Public Comment on the Revised Advance Beneficiary Notice (ABN)
• Jurisdiction B News: CMS Approves transition timeline for DME MAC Jurisdiction C
• NPIs Are Being Submitted Incorrectly on the New CMS 1500 Claim Forms (Paper Claim Submitters Only)
• The New Revised CMS 1500 (08-05) Claim Form is Now Available
• CMS Reminder: Keep Supplier Information Up to Date
• CMS surveys providers on contractor performance
  HME News
• NUCC Releases Updates to the Health Care Provider Taxonomy Code Set
• Additional Provider Education for Upcoming Changes in Payment for Oxygen Equipment and Capped Rentals for Durable Medical Equipment (DME) Based on the Deficit Reduction Act (DRA) of 2005
• Accreditation: `There is no more waiting`
  HME News
• CMS boosts PMD pricing
  HME News
• CMS released further revisions to the new power mobility device (PMD) fee schedules
• Jurisdiction B News: Claims Submitted With Only a NPI
• Jurisdiction B News: Upcoming Changes in Payment for Oxygen Equipment
• Implementation of PMD Policies in Effect
• CMS Announces Payment Changes for Medicare Home Health Services and Certain Medical and Oxygen Equipment
• Reopenings and Revisions of Claim Determinations and Decisions
• Evidence of Medical Necessity: Wheelchair and Power Operated Vehicle (POV) Claims
  Implementation Date: October 16, 2006
• Important Information Regarding Competitive Bidding and the Supplier Information Listed with the NSC
• NSC Top Ten Development Issues
• National Supplier Clearinghouse – NPI & CMS855S Update
• CODE RED: CMS SLASHES PMD PRICING
  HME NewsWire
• Medicare Issues Revised Local Coverage Determinations (LCD) for Power Mobility Devices
• Jurisdiction B News You Can Use: Update on Power Mobility Device and HCPCS
• Region A/B DME PSC Bulletin September 2006
• Pricing Sources for New HCPCS Codes for Power Wheelchairs Posted for Public Review and Comment
• Medicare payment hold begins September 22.
• Important Information Concerning The Provider Enrollment Application Process!!!
• Deficit Reduction Act of 2005 - 9-Day Payment Hold
  This message is a reminder for all providers who bill Medicare contractors for their services.
• MMA - Coverage for Home Use of Oxygen Included in Clinical Trials
  "Medlearn Matters"
• Wheelchair CMNs - New Instructions
• CMS Releases 64 New Power Mobility Codes
  HomeCare Monday
• New Power Mobility Codes Issued
• Attention All Suppliers - DME MAC Transition Dark Days
• Overview of the DMEPOS Reenrollment Process
  Suppliers must enroll every three years
• National Provider Identifier (NPI) Countdown
• Deficit Reduction Act (DRA) of 2005 - Payment for Oxygen Equipment and Capped Rentals for DME
  General Provider Education for Changes
• MLN Matters: DRA of 2005 Summary of O2/DME Payment Changes
• Important Information Regarding the Transition to the DME MACs, July 1, 2006
• National Provider Identifier (NPI) Stage 2 for Electronic Billers
• Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications
• BILLING NUMBER INFORMATION
  "PIN" and NPI Update
• CMS has announced the release of the revised CMS 855 Medicare enrollment applications.
• CMS has announced approved drug vendor information for the Competitive Acquisition Program (CAP.)
• CMS Announces Efforts to Streamline and Improve the Medicare Enrollment Process
• New DRA Provider "Education" Document Released
  O2 & Capped Rental Detail
• Medicare to Stop Mailing Standard Paper Remittance
  June 1, 2006,
• Form CMS-1500 (12-90) is being revised
• Nebulizers: CMS Issues Draft Local Coverage Determination
• RATC Update: CMS Issues Instructions to DMERCs about Power Mobility Claims
• CMS 855 Application Prescreening Process
  Effective February 11, 2006
• Change Payment Floor Date for Paper Claims
  Effective January 1, 2006
• Payment Provisions in the Original Medicare Program Immediately Affected by the Deficit Reduction Act
  2006 Fact Sheet
• Hold on Medicare Payments
  September 22,2006 - September 30, 2006.
• Change Payment Floor Date for Paper Claims
  27th day to the 29th date after receipt of a claim.
• Q & A about Provisions from Budget Bill that Affect Capped Rental HME and Home Oxygen
• Region D DME Benefit Integrity Support Center
• BIPAP CAP
• CMS revises payment classification for RADs
• CMS REVISES PAYMENT CLASSIFICATION OF CERTAIN RESPIRATORY ASSIST DEVICES
  Bi-level with backup now capped
• CMS Announces New DMEPOS Contractors
• Medicare Contractor Provider Satisfaction Survey (MCPSS)
  New annual survey
• Inherent Reasonableness (IR) Final Rule
• Supplying Fee/Dispensing Fee Revisions & Clarifications
  Oral anti-cancer chemotherapeutic drugs, oral anti-emetic drugs, immunosuppressive drugs, or inhalation drugs
• CMS Issues Clarification on Inhalation Drug Dispensing Fee
• Lawmakers delay decision on key PWC provision
  HME News
• Comment period closes for PWC rule
• Committee drops PWC reimbursement cut
• Power Mobility Devices – Grace Period for Implementation of the Interim Final Rule
• MMA - Evidence of Medical Necessity: Power Wheelchair and Power Operated Vehicle (POV)/Power Mobility Device (PMD) Claims
  Implementation occurs on October 25, 2005.
• MMA - New G Code for Power Mobility Devices (PMDs)
• CMS delays implementing new PWC codes
• Status of Activities Related to Power Mobility Devices (PMDs)
  October 14, 2005
• Proposed PWC reg holds docs accountable
  HME NewsWite
• MMA - Evidence of Medical Necessity: Power Wheelchair and Power Operated Vehicle (POV)/Power Mobility Device (PMD) Claims
  Update
• National Modifier and Condition Code To Be Used To Identify Disaster Related Claims
• Power Mobility Devices – Draft LCD – Corrections
  (September 14 original release)
• CMS Releases Draft of HME Supplier Quality Standards
• Wheelchair CMNs – Transition Instructions
• Power Mobility Device Draft Local Coverage Determination
• Power Mobility Device Draft Local Coverage Determination
  Includes Link To Draft Policy
• CMS Announces Special Open Door Forum on Power Mobility Devices
• CMS Interim Final Rule, “Conditions for Payment of Power Mobility Devices”
  RATC Update
• CMS drops CMN for power chairs
  HME News
• New Regulation on Power Mobility
• Overnight Oximetery Testing
• CMS: HME suppliers may deliver overnight pulse oximetry testing units to patients` homes
• CMS Eliminates Specialist Requirement to Prescribe Scooters, POVs
• DNF - "Do Not Forward" Initiative
  and ICD-9 Diagnosis Codes - New Specificity Guidelines
• ICD-9-CM Annual Update
  Update applies October 1, 2005
• New Address for ALJ Hearings Request
  Effective June 30, 2005
• CMS: Any kind of physician can prescribe a scooter
  HME Newswire
• FAQs: Mobility Assistive Equipment (MAE)
  June 2005
• CMS cuts DuoNeb reimbursement
  HME News
• CMS transitioning plans for NPI
• July 2005 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing
• Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
• OIG Begins Survey of Inhalation Drug Services; Accurate Response Is Critical
  AAHomecare
• CMS Releases Mobility Coverage Criteria; AAHomecare Will Continue Push to End "In-the-Home" Restriction
• DMERCS wait on NCD instructions from CMS
  HME News
• Long-awaited NCD draws criticism over `in-the-home` language
  HME News
• CMS Releases New Mobility Coverage Policy
  HomeCare Monday
• CMS: No sleep screening in the home
  HME News
• CMS Medlearn Matters Article on News DME Codes, Fees
• CMS expected to green light in-home oximetry
  HME News
• SADMERC Swamped with Coding Reviews
  HomeCare Monday
• CMS has finalized its decision not to expand coverage for in-home sleep testing
• Changes to AOB Regulations
• CMS delays issuing new PWC coverage criteria
  HME News
• SADMERC talks up 49 new PWC codes
  HME News
• CMS Change Request 3607 and How this Change Affects Suppliers of O&P
• 2005 Oxygen Fee Schedule Update
• Edwards: New Power Chair Codes Designed for Flexibility
  HomeCare Monday
• CMS prepares to release new coverage criteria for PWCs
  HME News
• Medicare keeps respiratory drug pricing stable
  HME News
• Power Wheelchair Coding Initiative (2004)
  SADMERC Frequently Asked Questions
• Providers wait: Still no word on Medicare oxygen cuts
  HME News
• Industry comments on proposed PWC criteria
  HME News 3/7/2005
• CMS grants portable concentrator a K code
  HME News 3/7/2005
• CMS Releases Interim Final Rule on Claims Appeal Reform
  HomeCare Monday 3/7/2005
• CMS proposes new wheelchair coverage criteria; PWC codes
  HME News
• The NSC TOP TEN
  "Reoccuring issues" that delay HME provider enrollment
• Expedite Power Chair Coverage Decision, Stakeholders Say
• CMS Resumes Oxygen Claims Processing
  HomeCare Monday
• CMS Update Regarding Oxygen Payments for 2005
  CMS TO BEGIN PAYING OXYGEN CLAIMS
• CMS seeking public comment on home sleep testing device decision
• New Year Has Mobility Stakeholders Watching and Waiting
  HomeCare Monday
• 2005 Payment Amounts for Oxygen and Oxygen Equipment
  2005 Update
• MMA - Drugs Paid by Average Selling Price Beginning January 1, 2005 for DMERC (revised)
  Effective 1/1/2005
• DME Competitive Bidding Committee Uncovers a Myriad of Issues
  HomeCare Monday
• Clarification of Proof of Delivery Requirements
• 2005 DMEPOS Fee Schedule Posted on VGM Website
• Important Change Request for O&P Practitioners
  Payment to Providers/Suppliers Qualified to Bill Medicare for Prosthetics and Certain Custom-Fabricated Orthotics
• More on Inhalation Dispensing Fee, Physician Fee Schedule
• CMS Finalizes Dispensing Fees for Respiratory Meds, Delays Ruling on Face-to-Face Exam
  HomeCare Monday
• CMS Announces Medicare Part B Wheelchair Seating Policy Update
• CMS ANNOUNCES REVISION TO WHEELCHAIR
• Attn: Diabetic Shoe Providers
• CMS Revises Wheelchair Cushion Fees
  HomeCare Monday
• Medicare Awards Contracts for Second-Level Claims Appeals
  HomeCare Monday
• CMS Unveils Demonstration Project for Managing Highest-Cost Beneficiaries
• FAQ: Clarification on the DMERC Advisories Relating to the New Codes for Wheelchair Cushions and Backs
• CMS considers “reasonable” reimbursement for respiratory meds
  HME News
• Industry Breathes Easier as Government Suggests Inhalation Drug Fees
  HomeCare Monday
• Reduced PWC Payments Could Bring $400 Million in Savings, OIG Says
  HomeCare Monday
• Revising the Healthcare Common Procedure Coding System (HCPCS) Process
  CMS Special Open Door Forum
• Summary of Power Wheelchair Coding Meeting
  September 1, 2004 CMS Public Meeting
• New Codes For Power Wheelchairs
  Reference Document
• CMS to Revise Coding Application Process
  HomeCare Monday
• Interim Medicare Fee Schedule Slashes Cushion Reimbursement
  HomeCare Monday
• Proposed "Face-to-face" Rule: Trap for the Unwary
  Dealer Provider
• CMS says it costs suppliers $5 to $8 to process CMN
  HME News
• CMS PUBLISHES INTERIM WHEELCHAIR CUSHION FEE SCHEDULE*
• Appeal Process
  The NSC has posted updated information
• CMS Asks for Public Comment on Certificates of Medical Necessity
• CMS Will Develop Guidance Documents for National Coverage Determinations
• CMS eliminating 90-day grace period ICD-9-CM codes,
  Effective October 1, 2004
• APPROVED NSCAC MEETING MINUTES WITH THE NSC
  8/10/04 CONFERENCE CALL
• Informational article: FEHB & Formal Spouse Coverage
• Update to Medicare Deductible, Coinsurance, and Premium Rates for Calendar Year (CY) 2005
• Filing Disaster Claims
• Sept. 1 rehab coding meeting encourages industry
  HME News
• Reminder - Elimination of the 90-day Grace Period for Billing Discontinued ICD-9-CM Codes
• Assignment of Benefit Form - Clarifications
• CMS Discusses Modernizing Coding Application Process
  HomeCare Monday
• CMS proposes new codes for power wheelchairs
  HME News
• OIG: Medicaid pays too much for oxygen
  HME News
• Medicare Replacement Drug Demonstration - Reminder
• FAA PROPOSES REG TO ALLOW TRAVEL WITH OXYGEN CONCENTRATORS
• CMS schedules hearing on new PWC codes
  HME News
• CMS Issues Corrected ICD-9 Code Set
• "In the home" takes center stage at open door forum
  HME News
• CMS expands provider e-mail service
  HME News
• CMS moves to develop new PWC eligibility guidelines
  HME News
• CMS helps covered entities understand new HIPAA edit requirements
• Florida Supplier Number Scheme Under Investigation, FAMES Reports
  HomeCare Monday
• CMS Permits Home Oxygen Testing Device
  HomeCare Monday
• New Insurance Requirements
• Florida Supplier Number Scheme Under Investigation, FAMES Reports
  HomeCare Monday
• MMA Reporting Provision Could Cause Medicare Payment Cuts
  HomeCare Monday
• NSC backs off draconian enforcement
  HME News
• MMA - National 1-800-MEDICARE (1-800-633-4227) Implementation
• 2004 Drug Fee Update for HCPCS codes J1563, J1564, J8520 and J8521
  Reductions based on DIMA
• Medicare Providers: Their Vendors, Clearinghouses, or Other Third-Party Billers and the HIPAA/Medicare Contingency Plan for DMERC
• CMS Working to Improve Provider Enrollment Process
• Government to reduce fraud and abuse for power wheelchair payments
• CMS wants fees for duplicate/incomplete claims
• CMS considers in-home sleep testing
  HME Newswire
• CMS Issues Interim Final Rule Addressing Physician Self-Referrals
• MMA - New Part B Annual Deductible
• CMS issues rule on physician self-referral, compensation
• Dialog on K0011 Coverage Set to Begin
  HomeCare Monday
• CMS ISSUES INTERIM FINAL RULE ADDRESSING PHYSICIAN SELF-REFERRALS
• Average sales price (ASP) update
• CMS rescinds DMERC effort to change scooter coverage
  HME News
• HERB KUHN NAMED TO HEAD MEDICARE CENTER
• CMS URGES STATES TO ADOPT DISEASE MANAGEMENT PROGRAMS, AGENCY WILL MATCH STATE COSTS
  Medicaid News
• Announcing the New Medlearn Matters
  Information for Medicare Providers Educational Resource for Medicare Providers Provider Types Affected
• ICD-9 Grace Period Rescinded – Effective October 1, 2004
• “Power Wheelchairs and POVs - Policy Clarification and Medical Review Strategy”.
  Q&A`s from Robert D. Hoover, Jr., MD, MPH, Medical Director, Region B
• CMS Introduces DMEPOS Information Source Web Page
• CMS Finalizes Outpatient Drug Reimbursement Reductions
• 2004 Fee Schedule Increase and Particpation Enrollment Extension
• HEALTH CARE SPENDING REACHES $1.6 TRILLION IN 2002
  CMS Office of Public Affairs 1/8/04 Press Release
• ABN Clarification from CMS
• CMS to Revise Home Health Market Basket; Revisit Part B Drug Determination
• Dennis Smith Named Acting CMS Administrator; Scully Joins Alston & Bird
• Former CMS head Scully joins law firm
• PROVIDER ALERT: STOPPING ABUSE OF THE POWER WHEELCHAIR BENEFIT
  From the Medicare Learning Network @ CMS
• Scully`s interim replacement steps up
• HHS Secretary Thompson to Step Down after 2004 Election
• DMERCs Issue Power Wheelchair Policy Clarification
  HomeCare Monday
• NSC Issues 760 New Supplier Numbers
  Where`s Your VGM Medicare Suppliers Guide?
• CMS Chief Scully Looks to Work as Industry Consultant
  Colin Roskey, health aid on Senate Finance Committee also quits
• CMS Makes $11.6 Billion in Errors for 2003
  DMERCs and DME suppliers, on average, showed a 13.6 percent error rate.
• Consolidation of the Claims Crossover Process
• CODING CHANGES A STEP CLOSER, BUT STUDY WARNS OF COST
• CMS FINALIZES NEW PROCESS FOR APPEAL OF COVERAGE DECISIONS
• CMS announces 2003 Medicare improper payment rate
• CMS lifts moratorium on supplier numbers
  HME News
• NSC Could Assign Some Supplier Numbers This Week
  HomeCare Monday
• 2004 Medicare Deductible, Coinsurance, and Premium Rates
• Lawmakers look to slash AWP reimbursement
  HME News
• REGION C’S METZGER JOINS THE SCOOTER STORE; FBI TARGETS NATION’S LARGEST POWER CHAIR PROVIDER
  from HME NewsWire
• CMS broadens appeal rights for Medicare beneficiaries
• Medicare Premium, Deductible & Coinsurance Changes
  2004 Update
• Scully: States, Feds Must be Partners in Medicaid Reform
• Medicare stalls on retesting Group I respiratory patients
  HME News
• ALERT! CMS indicates NSC supplier number deactivations no longer subject to moratorium!
  Some success seen from VGM member input and other efforts of last week
• ALERT: Medicare Announces Plan to Accept HIPAA Non-Compliant Electronic Transactions After October 16 Compliance Deadline
• CMS Transitions to Online Instructions System
• Medicare cracks down on booming power chair sales
  OIG Also Investigating DME Fraud
• CMS Manual :Transition from Paper to Web-based
  Beginning October 1, 2003
• IMPORTANT MESSAGE FROM THE NSCAC
  Re Blanket Moratorium on DMERC Numbers
• CMS Introduces DMEPOS Information Source Web Page
• Proposed Cuts Highlight Deeper Problem with Medicare Reimbursement, Experts Say
• CMS proposes changes to AWP methodology
• CMS PROPOSES AWP REFORM
• AWP - Separate Service Component
  AAHomecare
• JCAHO reapproved as hospice accrediting organization
• HHS names Corrigan acting principal deputy inspector general
• Part B Drug "Legislative Fix"
• OIG Issues Special Advisory on Suspect Joint Ventures
• CMS Issues Interim Final Rule On Imposition Of Civil Money Penalties
• CMS Publishes a Proposed Rule on Provider and Supplier Enrollment
• CMS clears ICD-9 confusion
• Must a DME supplier meet all of the 21 supplier standards?
• White House Releases Framework For Medicare Reform
• Congress Passes Budget as Health Care Reform Steals Spotlight
• Medicare DME grew by 20% in 2002
• CMS Addresses Ongoing Home Health, Hospice, and DME Issues at Open Door Meeting
• HCPCS codes by product classification available.
• OIG Warns Against DME Telemarketers