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 […]
On April 24, 2013, CMS announced that Medlearn Matters Article SE1213 had been revised to remove a statement that indicated that a prosthesis could be replaced without a new order from a physician as long as there was no upgrade from the previously ordered prosthesis. This statement was originally added to Medlearn Matters Article SE1213 […]
AOPA’s counsel on CMS matters, Tom Mills of the law firm Winston and Strawn, has issued a second letter to HHS Secretary Sebelius and CMS Acting Administrator Tavenner again seeking withdrawal of the “Dear Physician Letter” which unleashed the horrendous increase in RAC and other audits as well as burdensome prepayment reviews. All of these […]
The Centers for Medicare and Medicaid Services (CMS) has announced that it will implement Phase 2 of the PECOS referring/ordering physician edits for claims submitted on or after May 1, 2013. What this means is that claims for services ordered by a physician or other eligible provider who does not have an active enrollment […]
AOPA Executive Director, Tom Fise, brought the Board of Directors up to date in a recent email on how AOPA members attending the Policy Forum took the lead in urging their legislators in the House of Representatives to sign-on to the letter Rep. Tammy Duckworth and Rep Brett Guthrie will send to HHS Secretary Sebelius. […]
AOPA’s continuing conversation and efforts to convince CMS of the cash flow killing harm to patient care and member patient care facilities imposed by the pervasive and aggressive RAC audits together with aggressive AOPA member advocacy with their legislators flowing from the Policy Forum appears to have borne some fruit. The Centers for Medicare and […]
