Breaking Medicare News�.

DME Services of Texas, Inc. Medicare Update�

Medicare Payment Hold

A brief hold will be placed on Medicare payments for all claims during the last 9 days of the Federal fiscal year (September 22 through September 30, 2006).  These payment delays are mandated by section 5203 of the Deficit Reduction Act of 2005.  No interest will be accrued and no late penalties will be paid to an entity or individual by reason of this one-time hold on payments.  All claims held during this time will be paid on October 2, 2006.

This policy only applies to claims subject to payment.  It does not apply to full denials, no-pay claims, and other non-claim payments such as periodic interim payments, home health requests for anticipated payments, and cost report settlements.

Please note that payments will not be staggered and no advance payments will be allowed during this 9-day hold.

For more information, please view the MLN Matters Article at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5047.pdf.

Be prepared for the �Brief Hold��

Power Mobility Devices and Documentation Requirements

Palmetto GBA (Region C) has recently released new information regarding documentation for  Power Mobility Devices�click HERE  to view the new guidelines.  This article details what needs to be in the written order, gives time frames, and helps to clarify what is needed.  For example, you must now provide a written document that details

�         specific base HCPC code

�        manufacturer name/model

�        all options/accessories that will be separately billed

�        for claims with dates of service on or after 8/24/2006, you must list the supplier charge and Medicare allowable for each separately billed item.

The physician must sign and date this document AND the supplier must receive it PRIOR to delivery.  Be sure to read the entire article to get all of the details.

NPI

Another number?  You Bet!  The NPI is coming, and you should apply and get yours before the crunch begins.  You can read below about where to go to get your NPI�

As the industry transitions to NPI compliance, remember that there is no charge to get an NPI. Providers can apply online for their NPI, free of charge, by visiting https://nppes.cms.hhs.gov or by calling 1-800-465-3203 to request a paper application. The CMS NPI page, located at http://www.cms.hhs.gov/NationalProvIdentStand/, is the only source for official CMS education and information on the NPI initiative; all products located on this site are free of charge.

CMS continues to urge providers to include legacy identifiers on their NPI applications, not only for Medicare but for all payors. If reporting a Medicaid number, include the associated State name. If providers have already applied for their NPI, CMS asks them to go back into the NPPES and update their information with their legacy identifiers. This information is critical for payors in the development of crosswalks to aid in the transition to the NPI.

That�s all the news for now�thanks for reading!

Terry D. Henderson