Submit Comments on CMS’ Proposed Rule on O&P Qualified Providers On January 11, CMS released a proposed rule that would enact the long awaited provisions of Section 1834(h) of the Social Security Act, which establishes requirements for qualified suppliers and qualified practitioners, and restricts payments to providers who don’t meet those criteria. The proposal is […]
AOPA is celebrating its 100 year anniversary in 2017 and is proud to unveil its commemorative website, www.AOPA100.org. The website’s theme is “Your Story is Our Story” and features AOPA’s history, an interactive timeline, photo gallery, O&P stories from AOPA members, and AOPA’s plans for the future. Members are encouraged to share photos and memories […]
C2C Innovative Solutions, the Medicare appeals contractor who processes all DMEPOS appeals at the second level, also known as reconsideration, has announced implementation dates for its expansion of the formal telephone discussion demonstration. This program, currently limited to DMEPOS claims in Jurisdiction C and D, will be expanded to include claims for orthoses as of […]
As was stated in our notice last week, AOPA greatly applauds CMS for finally releasing the Proposed Regulation under BIPA 427. The proposal is far from perfect. That, coupled with: (a) the start of the new Trump Administration and the prospect that the Administration could easily view the Proposed regulations unfavorably as an effort to […]
This morning, CMS released a proposed rule that would enact the long awaited provisions of Section 1834(h) of the Social Security Act, which “requires that no Medicare payment shall be made for an item of custom-fabricated orthotics or for an item of prosthetics unless furnished by a qualified practitioner and fabricated by a qualified practitioner […]
On December 1, 2016 the Agency for Healthcare Research and Quality (AHRQ) announced that it was soliciting public comment on the key questions that would be used in its previously announced systematic review of clinical literature relative to lower limb prostheses. Comments were to be submitted no later than 11:59 pm on December 20, 2016. […]
On December 19, 2016, the Centers for Medicare and Medicaid Services (CMS) announced the initial implementation of the Medicare prior authorization program that was authorized through the final rule published on December 30, 2015. As expected, CMS has chosen a cautious approach in implementing its prior authorization program. The initial list of codes subject to […]
The 114th Congress completed its work in a “beat the clock” enactment around 11:30 pm on Friday evening, December 9 by the Senate passing a Continuing Resolution (CR) just 30 minutes before the government would have shut down. That Continuing Resolution will keep the U.S. government operating through April, and without enacting the provisions of […]
In mid-2014, the American Hospital Association (AHA) filed suit against HHS challenging the long delays—far in excess of the statutory limit of 90 days—before RAC audit appeal cases are heard by an administrative law judge (ALJ). Early on, the District Court ruled against AHA, but was overruled by the Court of Appeals. In now ruling […]
The Centers for Medicare and Medicaid Services (CMS) has released the 2017 Medicare DMEPOS fee schedule which will be effective for Medicare claims with a date of service on or after January 1, 2017. The 2017 Medicare fee schedule for orthotic and prosthetic services will be increased by 0.7% over 2016 rates. The 0.7% increase […]
