National Government Services (NGS), the Jurisdiction B DME MAC, recently reported results of their first quarter pre-payment audit activity on high error rate services, including orthotics and prosthetics. While the overall error rate for all claims reviewed remains relatively high at 72%, NGS reported that the error rate for O&P claims has been significantly reduced. […]
The Centers for Medicare and Medicaid Services (CMS) has published a draft document on its website that, in its words, “will assist physicians with documenting the physician notes that substantiate the need for a Lower Limb Prostheses.” AOPA believes that the draft template, in its proposed form, actually represents imposition by CMS of a serious […]
Last year the American Hospital Association (AHA) whose members are also under siege from RAC audits secured introduction of legislation that would be generally helpful to the plight of hospitals whose audit problems are Part A claims applying to hospitals only but are not unlike the RAC audit issues faced by O&P. But the AHA […]
More than 125 companies and individuals have responded with their pocketbooks to help fund the huge lawsuit expense of the AOPA lawsuit against CMS on behalf of members to stop the craziness that’s disrupting patient care and driving long time O&P providers out of business. $33,200, with contributions ranging in size from $100 to $3,000, […]
If you’ve had trouble getting through to AOPA staff it is because our phones have been ringing off the hook since we filed suit against Medicare. Members & Non-members have been asking, “How can I help?” Here’s how: Make donation to the AOPA Litigation and Research Fund Filing suit against the Medicare program is expensive; […]
As a reminder the Department of Health & Human Services (HHS) has published new rules/ updates to the HIPAA Privacy, Security, and Enforcement Breach Notification Rules; that were originally published as part of the Health Information Technology for Economic and Clinical Health Act or HITECH Act. Some of these updates include: Expanding the definition and […]
Noridian Healthcare Services, the Jurisdiction D DME MAC contractor has released the results from pre-payment reviews of claims for spinal; orthoses described by codes L0631 and L0637. For claims reviewed during the first quarter of 3013, the error rate for L0631 was 83% and the error rate for L0637 was 82%. In both cases, approximately […]
As a reminder the Department of Health & Human Services (HHS) has published new rules/ updates to the HIPAA Privacy, Security, and Enforcement Breach Notification Rules; that were originally published as part of the Health Information Technology for Economic and Clinical Health Act or HITECH Act. Some of these updates include: Expanding the definition and […]
AOPA would like to remind its members that revised limits for Additional Documentation Requests (ADRs) for RAC audits involving O&P claims were implemented as of April 3, 2013. While the ADR calculation remains unchanged at 10% of claims submitted during the previous year, divided by 8, for each 45 day period, CMS has limited the […]
American Orthotic & Prosthetic Association Files Lawsuit Against Medicare Arising from Unfair Medicare RAC/Pre-payment Audits, Where No Fraud Exists, and Challenges Unlawful Changes to Medicare Standard for Care of Medicare Amputees Today, the American Orthotic and Prosthetic Association (AOPA) filed suit against HHS/Medicare in the Federal District Court for the District of Columbia, seeking relief […]
