Legislative

Women’s health advocates ready to drum up support for legislation WASHINGTON – A recently introduced bill seeking Medicare coverage for wigs is an exciting step forward for women’s health, say advocates. “It’s a relatively inexpensive DME item but it certainly carries a lot of importance for a woman undergoing chemo—the hair loss is an extremely difficult piece,” said Mary Aframe, owner and founder of Women’s Image Center in Worcester

FOR IMMEDIATE RELEASE New Legislation Would Provide Medicare Coverage for Wigs to Cancer Patients Last week Rep. Jim McGovern (D-Mass.) introduced a bill which would provide coverage for wigs to Medicare beneficiaries. The bill, H.R. 2925 would allow wigs to be covered as durable medical equipment; opening access for Medicare beneficiaries that a dermatologist, oncologist, or attending physician can certify medical necessity as a part of rehabilitative treatment. Click here to read the full

You know the old slogan, “Do you want the good news first or the bad news?” Well, we are optimistic so we will give you the good news first. Good News – Mass Adjustments Starting in May not July! They are starting two months earlier than expected, AND providers do not have to take any action as these will be processed as a MASS ADJUSTMENT. Bad News – Mass Adjustments will Take Approximately 24 Weeks to Complete! Here’s what we know as of today: The DME MACs

DME contractor CGS announced on May 8 that it is preparing to begin mass adjustments to all claims covered under Section 16007 of the 21st Century Cures Act for DMEPOS items for jurisdiction B and C. It was indicated in CGS' announcement that the process will take approximately 24 weeks to complete, adjusting up to 40,000 claims per day in Jurisdiction C and 20,000 per day in Jurisdiction B. The van Halem Group published a blog post going into further detail about the announcement. Click here

A major win for DME Suppliers was announced yesterday, as CMS released information regarding improvements to the adjudication process of serial claims. Effective April 7, 2017, CMS has implemented changes to improve the processing and adjudication of recurring (monthly) claims for capped rental and certain inexpensive and routinely purchased (IRP) items. Prior to April 2017, if a monthly rental claim was denied and then appealed separately, then the claim was adjudicated independently and without

AMARILLO, TX - Assume that ABC Medical Equipment, Inc. is related to XYZ Medical Equipment, Inc. and DEF Medical Equipment, Inc. For example, assume that while the three companies do not have identical stockholders, John Smith and Jack Jones are stockholders of each company. Assume that ABC determines that Medicare paid claims to ABC that should not have been paid. Assume that ABC does not report and repay the overpayment to CMS. Assume that there is no evidence of improper claims submissions

When a Medicare beneficiary transitions to a new supplier, the DME MACs currently do not accept medical documentation from the original supplier. As we all know, this has been a burden on both the beneficiary and the new supplier. Change is about to happen. Effective April 24, 2017, the DME MACs WILL accept medical documentation from the original supplier when a beneficiary transfers to a new supplier.   What Does This Mean for the New Supplier? This means that, when a beneficiary switches

Pictured Above: Collin Brecher, VGM Government Relations, Jeri Millard and Kim Neel, EW Members and Nikki Jensen, EW Membership Director.   Lymphedema Advocacy Days Brings Patients and Providers to D.C. Dozens of patients, providers, and industry leaders met in Washington, D.C., to advocate for support of the Lymphedema Treatment Act (LTA). Nikki Jensen, membership director for Essentially Women, and Collin Brecher of VGM Government Relations, along with Sophia Hanson and Melvin

VGM Group, Inc. has submitted a formal letter of regulatory priorities to Department of Health and Human Services Secretary Tom Price. The letter outlines three top priorities that VGM's membership has identified that require immediate action from the administration in order to prevent reductions of access to care for Medicare and Medicaid beneficiaries. Action items listed include an implementation date of the retroactive delay to Medicare reimbursement cuts be moved up with an outlined

March is an important month for our industry. March is Lymphedema Awareness Month. As a provider of health care, you should take action to help raise awareness and support legislation efforts specific to coverage of medical products used to treat lymphedema. It will be of great benefit to your patients and your business. Let's review why you should take action today!   First, let's review the facts. Lymphedema affects two out of every five cancer patients, including those