Noridian Healthcare Solutions, the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare & Medicaid Services (CMS), is conducting post-payment reviews of Medicare DME claims for intermittent urinary catheters with dates of service from Jan. 1, 2022, through Dec. 31, 2023. In its announcement, Noridian referenced a February Washington Post story, “US Investigates Alleged…
Noridian SMRC Announces Post-Payment Review of 2022-2023 Catheter Claims
CMS Wants to Prevent ‘Barriers to Care’ in Medicare Advantage Programs, Add Guardrails Around AI
The Centers for Medicare & Medicaid Services announced policy changes last week.
The Centers for Medicare & Medicaid Services (CMS) is looking to further crack down on the companies that administer the privatized version of Medicare. On Nov. 26, CMS proposed new policies aimed at holding Medicare Advantage (MA) plans more accountable while removing “unnecessary barriers to care” for Medicare beneficiaries. The policies target “inappropriate” prior authorization…
Nov. 6 HCPCS Public Meeting to Include Discussion on CRT Seat Elevation, Joystick Hardware
NCART and Palmetto GBA have asked the Centers for Medicare & Medicaid Services to make coding changes.
The Nov. 6-8 second biannual HCPCS public meeting includes a request to revise the Medicare reimbursement for HCPCS code E2298, defined as Complex rehabilitative power wheelchair accessory, power seat elevation system, any type.” The applicant — the National Coalition for Assistive & Rehab Technology (NCART) — is recommending that language be changed to “Complex Rehabilitative…
Commentary: CRT As Prevention? What a Concept!
A new report published by VGM & Associates suggests Medicare competitive bidding has run its course.
A new report, authored by Brian Leitten of Leitten Consulting and published by VGM & Associates, contends that the Centers for Medicare & Medicaid Services (CMS) has taken the wrong perspective of durable medical equipment (DME) for at least for the last two decades. The 2003 Medicare Prescription Drug, Improvement, and Modernization Act gave rise…
CMS Raises CRT Seat Elevation Medicare Allowable by $13.62
Joel Kaiser, director of the division of DMEPOS policy, responded to NCART’s recalculation request.
The Medicare allowable for seat elevation on a Complex Rehab Technology (CRT) power chair is getting a very modest increase. In a June 25 bulletin, the National Coalition for Assistive & Rehab Technology (NCART) said it had been notified that the allowable for HCPCS code E2298 — Complex rehabilitative power wheelchair accessory, power seat elevation…
ReWalk Robotics Lauds Medicare Allowable for Personal Exoskeletons
The final payment rate affects claims with dates of service on or after April 1.
ReWalk Robotics Ltd. (DBA: Lifeward) is lauding the Centers for Medicare & Medicaid Services’ (CMS) decision to provide Medicare coverage for personal exoskeletons. In an April 12 announcement, ReWalk — which manufactures the ReWalk personal exoskeleton and the ReStore Exo-Suit, among other rehabilitation products — said, “The Centers for Medicare & Medicaid Services has officially…
Briefly: Medtrade Announces Attendance; Medicare Seat Elevation Coverage Now in Effect
Featuring Medtrade, NCART, and the Centers for Medicare & Medicaid Services.
Medtrade Reports Robust Growth in Dallas Attendance at Medtrade, held March 26-28 at the Kay Bailey Hutchison Convention Center in Dallas, grew by double digits, event officials said in a March 28 news announcement. “This year’s Medtrade attracted more than 2,300 qualified attendees,” Kerry Tyler, Medtrade’s associate show director, said. “That’s an increase of almost…
CMS to Allow Advance DME Payments Following Change Healthcare Cyberattack
Medicare announcement is an attempt to preserve health cash flows for health-care providers.
The Centers for Medicare & Medicaid Services (CMS) will consider advance payments to Part B suppliers experiencing disruption in claims payments after a cyberattack on Change Healthcare in late February. CMS announced the plan to accelerate payments on March 9. On its website, Change Healthcare, part of UnitedHealth Group, said it discovered the cyberattack on…
CMS Confirms Existing Medicare Funding Amounts for Dynamic Backs
The industry argued that dynamic backs are not comparable to wheelchair suspension systems.
The Centers for Medicare & Medicaid Services (CMS) has stated that existing Medicare reimbursement for dynamic wheelchair backrests is appropriate based on its analysis. That decision was part of the CMS Healthcare Common Procedure Coding System (HCPCS) Level II Final Coding, Benefit Category and Payment Determinations, Second Biannual 2023 HCPCS Coding Cycle, released at the…
CMS Issues Final Coding, Benefit Category, Payment Determinations for Seat Elevation
New coding will go into effect in April.
The Centers for Medicare & Medicaid Services (CMS) has issued its final coding, benefit category, and payment determinations for seat elevation on power wheelchairs. The determinations were included as part of CMS’s Second Biannual 2023 HCPCS Coding Cycle. CMS said new coding actions would be effective starting April 1, 2024, unless otherwise noted. CRT industry…