Programs
Regulatory Updates
Total of 180 Records Returned
State: All
Continuous Positive Airway Pressure Devices & Accessories: Prevent Claim Denials
Date Posted : 01/16/2025
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
Learn how to bill correctly for these services. Review the Continuous Positive Airway Pressure Devices & Accessories provider compliance tip for more information, including:
- Billing codes
- Denial reasons and how to prevent them
- Refill and documentation requirements
State: California
California Wildfires Public Health Emergency: CMS Resources and Flexibilities
Date Posted : 01/10/2025
Program:
On January 10, 2025, the Department of Health and Human Services determined that a Public Health Emergency (PHE) exists in California and was effective January 7, 2025. CMS issued a news alert and has a webpage available to assist providers in requesting waivers as well as what waivers and flexibilities are already available.
Read MoreState: All
DMEPOS – Patient Eligibility Unavailable on Interactive Voice Response (IVR)
Date Posted : 01/3/2025
Date Effective : 03/1/2025
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies, Pharmacy
In accordance with CMS Change Request (CR) 13754, to protect beneficiaries from possible fraud, the Centers for Medicare and Medicaid Services (CMS) has required all Medicare Administrative Contractors (MACs) to disable eligibility information from their IVR systems by March 2025. Once disabled, CMS will require all providers and suppliers to check beneficiary eligibility through one of the following self-service tools:
- MAC secure online provider portal
- Billing agencies, clearinghouses, or software vendors
- Health Insurance Portability and Accountability Act (HIPAA) Eligibility Transaction System (HETS)
- Part A and Part B entitlement dates
- Current/prior year Part B deductible information
- Current/prior year physical therapy and occupational therapy limit amount used
- ESRD coverage dates, dialysis and/or transplant date
- HH+H name, NPI, address and effective/termination dates
- Certain Preventive care details
State: All
Medicare Telehealth Flexibilities Extended through March 31, 2025
Program: Home Health, Hospice
Congress recently passed a bill that will allow for certain telehealth flexibilities to extend until March 31, 2025. This includes the ability to perform telehealth Face to Face encounters for home health and hospice. We will continue to monitor for further developments.
Read MoreState: All
CMS Resource: Transition to All-Payer Oasis Data Collection and Submission
Program: Home Health
CMS has released an easy-to-use resource to help providers better understand agency action items leading up to the mandatory collection and reporting of OASIS data for all payer types effective July 1, 2025. This resource also provides a link to the OASIS-E1 manual.
Read MoreState: Texas
Texas HHSC PL 2025-01: New Emergency Communication Tool – AlertMedia
Date Posted : 01/7/2025
Program: Assisted Living, Home Care, Home Health, Home Infusion Therapy, Hospice
On January 7, 2025, Texas Health and Human Services Commission issued Provider Letter 2025-01 New Emergency Communication Tool - AlertMedia. The provider letter is applicable to all providers in the Long-Term Care division including hospices, home and community support services, and assisted living facilities. Providers should review this provider letter for policy details and provider responsibilities. Provider responsibilities must be met no later than February 15, 2025.
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Accreditation Commission for Health Care, Inc.