The Centers for Medicare & Medicaid Services (CMS) continues to issue policy changes that impact O&P claims audits and other matters of interest to O&P practitioners. CMS issued new limits on how many claims Recovery Audit Contractors (RACs) can seek to review in a given period. One of the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) issued a report finding a 99-percent error rate in its review of custom AFO claims, largely due to a lack of physician documentation. CMS also issued-and then rescinded-a transmittal impacting the ability of an O&P business from enrolling in the Medicare program if overpayments are pending, and the Office of the Inspector General (OIG) issued a report on CMS’ lax enforcement of surety bonds to collect overpayments of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). This article contextualizes these developments as they relate to the O&P profession.
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