HHS OIG Examines PMD Repairs
On May 31, 2022, the Department of Health and Human Services Office of Inspector General (OIG) published a report titled, “Medicare Improperly Paid Durable Medical Equipment Suppliers an Estimated $8 Million of the $40 Million Paid for Power Mobility Device Repairs.” The OIG sampled 922 PMD repairs from October 1, 2018- September 30, 2019 and found that 637 met Medicare requirements. The OIG reports that 217 of the 922 PMD repairs did not meet Medicare requirements.
Based on the findings, the OIG estimates $8 million of the $40 million Medicare paid during the audit period were improperly paid. The OIG provided several recommendations to CMS and Medicare contractors including improving supplier education on PMD repair claim submission and recovering overpayments associated with the 217 PMD repairs. You can find AAHomecare’s summary of the report here.
CMS Revises CMN and DIF Requirements in Public Health Final Rule
On June 3, the DME MACs published a revision regarding their directions related to the Public Health Emergency Interim Final Rules. Specifically, CMS published a revision regarding the CMN and DIF requirement, stating that CMN for oxygen and DIF for external infusion pumps are not required during the PHE. The publication states:
There is no requirement to submit a CMN or DIF during the PHE for oxygen or [external infusion pumps] EIPs. If CMNs or DIFs are not submitted, suppliers must use the CR modifier and COVID-19 narrative for any oxygen or EIP claims submitted during the COVID PHE. CMNs or DIFs are not required regardless of the diagnosis or etiology necessitating the use of the CMN-related or DIF-related DME. Use of the CR modifier and COVID-19 narrative simply reflects that the claim was submitted during the COVID PHE. Find DME MAC’s full revision here.
AAHomecare Develops FAQs on Ventilator EUA
In March 2020, the Food & Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to address the insufficient supply and availability of FDA-cleared ventilators for use in health care settings to treat patients during the COVID-19 Public Health Emergency (PHE).
Leaders on AAHomecare’s Regulatory Council have developed a brief FAQ document that provides an overview on the EUA and includes info on additional resources to help suppliers determine what devices are covered.
Please note that the FAQ document is provided as an informational service by AAHomecare and does not constitute legal advice. We recommend that you consult the FDA and your regulatory counsel if you have additional questions.