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Medicare Provider Enrollment Updates: What you need to know NOW!

The Centers for Medicare & Medicaid Services (CMS) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment...

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Recent Blog Posts

Medicare Provider Enrollment Updates: What you need to know NOW!

The Centers for Medicare & Medicaid Services (CMS) continued its efforts to increase oversight of the Medicare program by updating Medicare provider enrollment regulations. Specifically, updates have been made to Medicare’s provider and supplier...

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2024 Audit and Compliance Forecast

By Wayne van Halem, President, The van Halem Group What can you expect to see from an audit and compliance perspective in 2024? I think it’s going to be an interesting year. There are a number of things happening that could impact our clients....

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Reminder: Annual Medicare Participation Announcement

Every year from mid-November through December 31, providers can decide if they want to participate in Medicare for the upcoming year. In early to mid-November, your MAC will send a post card reminding you about the annual participation open enrollment...

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CMS makes changes to CGM supply billing

CMS announced that, effective January 1, 2024, suppliers will be able to bill CGM supplies in 90 day increments.  According to change request CR13397, the purpose of this Change Request (CR) is to instruct Medicare  Administrative Contractors...

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Audit Alert: SMRC adds lumbar-sacral orthoses to current projects list

Noridian Healthcare Solutions, LLC, (Noridian) as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid Services (CMS), is conducting post-payment review of claims for select Medicare Durable Medical Equipment (DME)...

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Friday FAQ

Question: I am just starting a new home medical equipment business. How can The van Halem Group help? Answer: At vHG, we offer a variety of services for new DMEPOS suppliers, including assistance with getting your business accredited and enrolled...

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DMEPOS: New Provider Enrollment Appeals & Rebuttals Contractor Starts October 9

On Thursday, October 5, 2023, CMS announced that the last day the National Supplier Clearinghouse (NSC) will accept provider enrollment appeals and rebuttals is Friday, October 6, 2023. Beginning Monday, October 9, 2023, all provider...

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Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization

By Kelly Grahovac, General Manager, The van Halem Group In recent months, the Office of Inspector General (OIG) has been working to update their compliance guidance. This was first apparent in the revisions made to corporate integrity agreements (CIAs)...

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Audit Alert: UPICs focus on CGM and supplies

The van Halem Group has identified an increase in UPIC audit requests for CGM and supplies for both pandemic and current dates of service. The UPICs are auditing providers on both a prepayment and postpayment basis. CMS recently indicated that they wanted...

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Changes to EFT authorization agreement form (CMS-588) submissions

Effective August 21, 2023, Electronic Funds Transfer (EFT) Authorization Agreement Form (CMS-588)  must be sent to the applicable National Provider Enrollment (NPE) contractor for the supplier’s physical location. Please refer to the below...

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