On November 1, 2018 the Centers for Medicare and Medicaid Services (CMS) published a final rule that addressed changes to the DMEPOS Competitive Bidding program and potential changes to the gap filling methodology that is currently used to establish Medicare fee schedules for new HCPCS codes. The final rule followed a proposed rule that was […]
On November 1, 2018, the four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) released an updated Local Coverage Determination (LCD) for lower limb prostheses. Since the changes to the LCD were minimal and do not restrict coverage, the notice and comment period required by the 21st Century Cures Act does not apply to this […]
On January 01, 2016, CMS launched the QIC Telephone Discussion Demonstration project to determine if engagement between suppliers and the QIC could improve the understanding of the cause of appeal denials, and lead to increased proper claim submissions. The project was originally only limited to certain DME claims, however in October 2016, the projected was expanded […]
The Centers for Medicare and Medicaid Services has announced that it will hold a special Open-Door Forum conference call to educate the public about a new initiative tasked with developing an online resource where providers and suppliers can look up the documentation requirements necessary for Medicare to cover a service or item. While the initiative […]
The four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have recently released a revised version of the “Dear Physician” letter that addresses the need for prescribing physicians to support the medical necessity of the DMEPOS services they prescribe through proper clinical documentation in the patient’s medical record. While the revisions to the Dear Physician […]
The American Orthotic & Prosthetic Association (AOPA) in partnership with The Journal of Neuroengineering and Rehabilitation, JNER, a BioMed Central journal partner, is pleased to announce that the supplement, “Advancements in Prosthetics and Orthotics: Selected articles from the Second World Congress hosted by the American Orthotic & Prosthetic Association (AOPA)” has been published today. The […]
On October 1, 2018, AOPA submitted comments on a draft policy governing coverage of lower limb prostheses, including microprocessor-controlled prostheses issued by Health Care Services Corporation (HCSC), which operates Blue Cross Blue Shield of Illinois, Texas, Montana, New Mexico, and Oklahoma. The draft policy, as written will significantly reduce access to advanced prosthetic technology for […]
AOPA Submits Comments Regarding Improving the Medicare Gap Filling Process On September 10, 2018, AOPA submitted formal comments to CMS regarding suggestions on how to improve the “gap filling” process that is currently used to establish Medicare fee schedule amount for new HCPCS codes. The opportunity to provide comments was the result of the annual […]
As many AOPA Members may already be aware, earlier this week, the Department of Veterans Affairs Office of Inspector General (VA OIG) issued a report regarding VA overpayments for prosthetic devices described by not otherwise classified (NOC) procedure codes. The full report may be accessed here. The key paragraph in the report addresses purported overpayment […]
O&P News Special Announcement The American Orthotic and Prosthetic Association (AOPA) continues its stride toward innovation by creating an online presentation and platform for O&P News. With an efficient website and click-ready flip-book, advertisers are more likely to garner viewership and gain exposure in the overall health-care arena. As always, AOPA strives to provide the […]
