The indictment of a Detroit area sham therapy operation was announced this summer, and in a United States Department of Justice (USDOJ) press release on Monday, the main conspirator plead guilty to a $18.2 million scheme to defraud the Medicare program.  According to the DOJ press release “…Chand admitted that in order to create the [...]

National Government Services (NGS) has posted the schedule for their first ever virtual Medicare University Convention to be held November 16-20, 2009.  Last year this convention was held as a live event in Indianapolis, and citing the significant savings in travel and expense, NGS has announced a reduction in the registration fee from $175 to [...]

There seems to be a bit of panic spreading in the therapy community, that is more of a misunderstanding regarding the standing of private practice therapists providing DME supplies for their patients.  There seems to be a particular concern for those providing hand therapy services including splints, and wondering if they have to meet the [...]

CMS Issued New “Final” Recouping Regulation, at 42 CFR 405.370, 405.378, 405.379.  The effect of this rule is to shorten providers decision making time in making appeals on overpayment demands.    Recouping involves a Medicare Contractor holding back reimbursement to offset monies that a provider is deemed to owe to the Medicare Program.  According to CMS [...]

With the Region A RAC adding three issues over this past weekend, including a new issue of Pharmacy Supply and Dispensing Fees, all four of the Recovery Audit Contractors are now on board with automated review underway.  During the RAC roll-out process, often referred to as ‘town hall meetings” CMS as well as the four [...]

 Automated reviews of rehab untimed codes are underway by the Recovery Audit Contractors in Region C & Region D.  It is entirely possible that rehab providers have received recoupment letters as you read this.  Simultaneously within CMS the conversion from fiscal intermediaries and carriers to the Medicare Administrative Contractor format has resulted in the development/conversion [...]