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CMS opens access to respiratory therapy


WASHINGTON – Medicare will cover respiratory related devices and equipment for any medical reason determined by clinicians during the coronavirus pandemic, CMS announced last night.

Inspire touts coverage win


MINNEAPOLIS – Two Medicare Administrative Contractors, Noridian and Palmetto, have published draft local coverage determinations that propose coverage for Inspire Medical Systems’ obstructive sleep apnea therapy, according to the company.

Inspire racks up more coverage by private payers


MINNEAPOLIS – Inspire Medical Systems has added 10.4 million covered lives with several new coverage policies.

What’s up with this ‘What’s Covered’ app?

Thursday, January 31, 2019

CMS this week has made much ado about its new “What’s Covered” app that allows beneficiaries to see whether Medicare covers a specific medical item or service, which of course includes HME.

Medicare keeps coverage for wheelchair trays


WASHINGTON – Medicare made a clerical error when it said it considered wheelchair trays, tables or similar products convenience items.

Don’t expect CMS to remain silent on vents, Stark says


COLUMBIA, S.C. – CMS is not done tinkering with coverage guidelines for vents, predicts consultant Andrea Stark.

DME MACs clarify vent requirements


WASHINGTON – In highly anticipated clarifications on coding and coverage requirements for ventilators, the DME MACs have acknowledged that coverage for the product category isn’t quite black and white.

O&P stakeholders add bill to arsenal


WASHINGTON – Rep. Renee Ellmers, R-N.C., has introduced a bill that would halt CMS’s plans to make dramatic changes to coverage for prosthetic devices.

Researchers, former senator join fight


WASHINGTON – Nine leading U.S. researchers and a former U.S. senator have put pen to paper in the fight against proposed changes to coverage for lower limb prostheses.

Change to enteral nutrition impacts claims payment

Monday, July 6, 2015
Andrea Stark
reimbursement consultant, Mira Vista

A new enforcement of quantity details on detailed written orders for enteral nutrition is manifesting in claim denials.