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Episode 38: Back to Basics, 4 Ps for HME Retail Cash Sales

Published in Retail Expertise on August 27, 2019

Wes Hopper, Field VP Strategic Sales for McKesson Medical Surgical, joins host Brian Thompson to discuss the retail cash sales opportunity in the DMEPOS marketplace.

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From Our Experts

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Featured Service: The van Halem Group There's been a lot of questions and confusion surrounding telehealth services and how they relate to DMEPOS claims. This article by Wayne van Halem, originally featured in “VGM Playbook: Technology and the Patient Care Continuum Guide to Remote Work,” addresses whether or not telehealth services can be used to qualify a patient for an item of DMEPOS during the PHE.

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Return of the Audits HME Business recently wrote about the news that CMS planned to resume audits by Aug. 3 and that it took many by surprise. Then CMS said it would resume audits in a phased approach. What are the details and what can providers expect?

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CMS Audits Resume August 3, 2020 In this episode, we chat with Wayne van Halem and Kelly Grahovac of The van Halem Group about the CMS audits returning today, August 3, and what DMEPOS providers need to know.

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Member Q&A From The van Halem Group: New Order Requirement and "Master List" I'm curious about this new order requirement. I see that Medicare updated the notice on 2/12/20, and I'm curious about the “Master List” of items that still needs a WOPD. I'm wondering if PAP equipment and supplies fall under the SWO or the WOPD. Can you help me understand?

The Cost of Compliance – An Impassioned Plea to be Proactive Last year, The van Halem Group was engaged by several DME providers that were subject to a 6-year OIG lookback audit. Sadly, for companies that did not have a process in place for proactive chart audits, the 6-year look back resulted in a very expensive lesson. Lookback audits are here to stay, and it's never been more important for providers to have a comprehensive proactive compliance program, and this is one way that The van Halem Group can assist members.

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OIG to Review PMD Repairs and PAP Supplies The Office of Inspector General (OIG) has updated its work plan to include new reviews for PAP replacement supplies and power mobility device repairs. In a recent article from HME News, Medicare paid approximately $945.8 million for replacement supplies in 2017 and 2018, but OIG has previously found that most claims did not comply with Medicare requirements and that DME suppliers often did not have the documentation required to support the need for replacement supplies.

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Are Inhalation Drugs the Next OIG Six Year Lookback Audit? Since 2010, the CMS's Comprehensive Error Rate Testing (CERT) program has identified nebulizers and related drugs (i.e., inhalation drugs) among the top 20 supplies with the highest improper Medicare payments. Based on prior reviews, the Office of Inspector General (OIG) conducted a nationwide review to determine if the suppliers included in the review complied with Medicare requirements when billing for inhalation drugs.

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Ronda Says: Are You Ready for Oct. 21? Group II Support Surfaces Enter Prior Authorization Program for All States CMS announced in Dec. 30, 2015 a finalized rule creating a program called Condition of Payment Prior Authorization Program for Certain DMEPOS items.

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