News

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Important Update Regarding RAC Announcement On Audit of L5845 – Issue Has Been Removed from the RAC Website

In the April 20, 2017 AOPA in Advance: SmartBrief newsletter, AOPA announced that Performant Recovery, the contractor who serves as the national recovery audit contractor (RAC) for all Medicare DMEPOS, Hospice and Home Health services, had announced that it would begin performing an automated review on claims involving HCPCS code L5845 billed in conjunction with specific […]

AOPA Announces Free Prior Authorization Webinar for Members

CMS will be implementing Prior Authorization February 29, 2016 for certain DMEPOS items that included lower limb prosthesis. What does this mean for YOU? AOPA is pleased to present the beginning of our educational efforts related to Prior Authorization. Please join AOPA for an AOPA Member Exclusive introductory webinar on Prior Authorization, with 2 dates […]

Congress Close to a Deal on Funding of the Federal Government; Modest Potential Impact on O&P and Suspension of Medical Device Excise Tax for Non-O&P in Play

On Wednesday, December 16th, President Obama signed a short term spending measure that will allow the Federal government to continue to operate until December 22, allowing Congress to finalize its long anticipated Omnibus appropriations and tax break extender legislation that will fund the Federal government for the remainder of the 2016 fiscal year.  Two important […]

AOPA and O&P Alliance Meets with CMS Deputy Administrator Dr. Shantanu Agrawal

On June 3, the O&P Alliance, including AOPA’s President Charles Dankmeyer, and Executive Director Tom Fise, JD, met with the Deputy Administrator and Director of the Center for Program Integrity at CMS. The meeting included several topics: local coverage determination (LCD) recognition of O&P clinicians’ notes as part of the medical record; who can bill […]

Renewed Hope for Relief from Recent O&P Challenges – Medicare O&P Improvement Act

Seldom does a single piece of legislation do so much for a vital segment of patients and healthcare providers as does the new version of the Medicare O&P Improvement Act of 2015 introduced by Sen. Grassley (R-IA) and Sen. Warner (D-VA) in the Senate (S. 829).  The House bill (H.R. 1530 was introduced by Rep. […]

STUDY:  MEDICARE AUDIT “MESS” SURGING AT RATE OF 15,000 NEW APPEALS PER WEEK, AGENCY COULD AVOID RAPIDLY MOUNTING INTEREST PAYMENTS

 AOPA:  More than 100 Small Health Care Providers Already Shut Down Due to Delays and Many More at Risk; No End in Sight to Estimated Backlog of 1.5 Million Appeals Now Languishing. WASHINGTON, D.C.///March 19, 2015///With a massive backlog of Medicare reimbursement appeals by health care providers growing at the alarming rate of 15,000 a […]

2015 Medicare DMEPOS Fee Schedule Released

The Centers for Medicare and Medicaid Services (CMS) has released the 2015 Medicare DMEPOS fee schedule, effective for claims with a date of service on or after January 1, 2015. The net Medicare fee increase for O&P services for 2015 is 1.5%.  This is based on a 2.1% increase in the consumer pricing index for […]

CMS Issues Final Rule on OTS Orthotics

CMS Reverses Fields, Scuttles Current Process for Redefining Orthotics, and for Limiting Scope of Practice for Certified Orthotic Fitters Late on Friday afternoon, October 31, CMS released the massive final rule covering end stage renal disease payments and a host of other topics, including its proposal to further amend the regulatory definition of “minimal self-adjustment,” […]

Two Leading Senators Write CMS to Support AOPA View, and Insist That CMS Observe Narrower View of “Minimal Self-Adjustment” in OTS Orthotics

Read the important letter to CMS Administrator Tavenner from Senators Chuck Grassley (R-IA) and Tom Harkin (D-IA).  The letter speaks for itself, but its essence is to directly challenge CMS for exceeding the simple and straightforward statutory language “minimal self-adjustment” in defining off-the-shelf orthotics. These leading legislators, both of whom were in the Senate about a decade […]

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