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How to Grow and Manage a Thriving HME Business Amidst Audit and Compliance Landmines

The HME industry is a vital part of the healthcare ecosystem, providing essential services and equipment to patients in need. However, navigating the complex landscape of audits and compliance can be challenging. While the goal is to grow your HME business,...

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Compliance with the HIPAA Privacy Rule to Support Reproductive Healthcare Privacy

On April 22, 2024, the Office for Civil Rights (OCR) issued a Final Rule, entitled HIPAA Privacy Rule to Support Reproductive Health Care Privacy. The Final Rule strengthens the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy...

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What is the OIG’s List of Excluded Individuals/Entities (LEIE) database and why should I care?

As part of your compliance program, providers should regularly check to ensure employees and business associates have not been identified as an excluded individual with the Office of Inspector General (OIG). The OIG has the authority to exclude individuals...

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SMRC adds Urinary Catheters to their Current Projects list

Noridian Healthcare Solutions, LLC (Noridian), as the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare and Medicaid (CMS), announced that they are conducting post-payment review of Medicare DME intermittent...

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Telehealth flexibilities to expire at end of year without congressional intervention

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B...

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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 regulations. Specifically, updates have been made to Medicare’s provider and supplier...

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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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Navigating the Evolving Compliance Landscape: Guidance and Implications for Your Organization
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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Power Mobility Device (PMD) Accessory Voluntary Prior Authorization

CMS added the following PMD accessory HCPCS codes for voluntary authorization. The goal of this process is to increase operational simplicity by allowing suppliers to request prior authorization for a PMD accessory. The DME MACs will begin accepting...

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Final Continuous Glucose Monitor (CGM) policy released

Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with...

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