Post-PHE: Brush Up on Rules to Guard Against Audits

Published in Government Relations on June 28, 2023

RondaB

This article was originally featured in HME News

With the public health emergency officially over, HME providers need to prepare for a return to “normal” – including a return to audits, say industry stakeholders. 

On April 28, ahead of the PHE ending on May 11, CMS published directions for claims impacted by the COVID-19 pandemic. Among the agency’s guidance: Continue to use the CR modifier for rentals and supplies, and return to proof of delivery with a patient’s signature. 

“During the pandemic, there were patients that said, ‘I’m not going to sign that delivery ticket,’ so the supplier used COVID-19 as the signature and used the CR modifier when they billed the claim,” said Ronda Buhrmester, senior director of payer relations and reimbursement for VGM & Associates. “Post-PHE, that COVID signature is no longer allowed.” 

Stakeholders fully believe that claims with CR modifiers will be subject to scrutiny, so Dan Fedor, national director of coding and reimbursement for U.S. Rehab, recommend providers “do a recount and make sure they have what they need.” 

“It’s confusing,” he said. “There’s a lot of changes, a lot of waivers. Normal policy is confusing and then add in this. Providers need to make sure they are 100% prepared, not 90% prepared.” 

Another area where stakeholders expect auditors to be thorough: telehealth visits. While CMS has extended flexibilities around telehealth through Dec. 31, 2024, and while there was leniency during the PHE for treating practitioners to conduct audio-only visits, DME providers now need to make sure visits include audio and visual to bill these claims, stakeholders say. 

“Auditing groups are really going to be looking at those claims to make sure they meet the coverage criteria,” she said. 

Buhrmester recommends providers archive articles and FAQs put out by CMS in their own forms library. 

“Download it now so whenever those audits happen, whether it’s now, one year or two years, you’ll have that information,” she said.  

From Our Experts

The Big Sky Association of Medical Equipment Suppliers Welcomes UTAH! thumbnail The Big Sky Association of Medical Equipment Suppliers Welcomes UTAH! The Big Sky Association of Medical Equipment Suppliers is pleased to announce that Utah has officially been accepted into the association as our newest participating state. Big Sky now proudly welcomes all Utah DME/HME, Respiratory, CRT, and Medical Supply companies into our regional association. Utah will have a designated state representative/director—appointed in the same manner as Montana, Idaho, and Wyoming—to ensure strong representation and a clear voice within the Association. Beyond the Shutdown and The Proposed Rule: Key Legislative Updates for the HME Industry thumbnail Beyond the Shutdown and The Proposed Rule: Key Legislative Updates for the HME Industry While the government shutdown and uncertainty surrounding CMS's Proposed Rule have dominated headlines, several important bills impacting HME providers continue to advance. Here's a quick look at three focused legislative priorities: Advocacy in Action: Texas DME Providers Stand Up For Patient Care thumbnail Advocacy in Action: Texas DME Providers Stand Up For Patient Care Texas DME providers are speaking out against proposed Medicaid reimbursement rate cuts that threaten access to essential medical equipment for vulnerable patients. At a recent public hearing, voices from across the state shared powerful stories about the real-world impact of these cuts—some as high as 85%. The Shutdown Has Ended—Now It's Time To Take Action thumbnail The Shutdown Has Ended—Now It's Time To Take Action The recent government shutdown created uncertainty across the healthcare landscape, and the DMEPOS community was no exception. In the weeks ahead, critical decisions will shape the future of our industry. By getting involved early—through advocacy, education, and collaboration—you can help ensure these policies support patients and providers rather than hinder them. Notably, the Continuing Resolution (CR) includes an extension of Medicare telehealth flexibilities through January 2026... New Issue Brief: Why Medicare's Competitive Bidding Program Needs Urgent Reform thumbnail New Issue Brief: Why Medicare's Competitive Bidding Program Needs Urgent Reform The Medicare competitive bidding program for durable medical equipment (DME) was designed to reduce costs—but it's failing patients and providers. A new issue brief from Pacific Research Institute and economist Wayne Winegarden highlights what changes are urgently needed. Champions of Change: DME Advocates Driving Real Change thumbnail Champions of Change: DME Advocates Driving Real Change Real change starts with real people. In this edition of Champions of Change, we're spotlighting two DME advocates who aren't just talking about problems—they're taking action. David Griffin and Gary Rench are showing us what it means to stand up for patients, providers, and the future of our industry. Join HME Industry Letter on CB Program to CMS Administrator Oz thumbnail Join HME Industry Letter on CB Program to CMS Administrator Oz HME suppliers, manufacturers, and distributors are invited to add their company's name to a letter to CMS Administrator Dr. Mehmet Oz regarding the Administration's DMEPOS/Home Health Proposed Rule that includes provisions for a new competitive bidding round. The letter specifically asks CMS to withdraw or delay the DMEPOS provisions in the Proposed Rule and re-engage with industry, patient, and clinical stakeholders to design an evidence-based, fraud-resistant, America-First framework. Take Action Today: Urge CMS to Pause and Re-Evaluate the Competitive Bidding Program thumbnail Take Action Today: Urge CMS to Pause and Re-Evaluate the Competitive Bidding Program Now is the time to raise our voices. With the formal announcement of the Competitive Bidding (CB) Program expected as early as the end of this month, we must act swiftly and decisively. Below are two key opportunities to engage with your U.S. Representative and encourage their support for a Congressional letter urging Centers for Medicare & Medicaid Services (CMS) to pause and reassess the CB Program.