Client Services
Medical Director
Medical Policy Reviewer I – Part Time
OIG Work Plan and Enforcement Actions
Steven A Greenspan JD LLM There are a couple of powerful auditors looking at fraud, waste, and abuse in the healthcare arena with whom you hope to never have the pleasure of interacting. One is the Health and Human Services (HHS) Office of Inspector General (OIG). It is the largest inspector general’s office in the …
CMS Issues Additional Payment Edits for DMEPOS Suppliers
Steven A Greenspan JD LLM CMS Adds Five (5) States Requiring Licensure & Enrollment with NSC The Centers for Medicare and Medicaid Services (CMS) issued Transmittal 11002, Change Request (CR) 12282 (r11002otn.pdf (cms.gov), on September 13, 2021, to communicate the addition of HCPCS codes that require the use of a licensed/certified orthotist or prosthetist for …
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CMS Voluntary Refunds -Concerns for Providers
William OMalley Medicare expects providers to exercise care when billing and accepting payment. Medicare also expects that providers will promptly bring incorrect payments to the Medicare Administrative Contractor’s (MAC) attention. First Coast Service Options (FCSO), on December 17, 2021, issued a notification to Medicare providers explaining that, at times, providers receive incorrect payment, such as …