for Round 1 areas in 2017. This next round is to begin once the current Round 1 Recompete contracts expire on December 31, 2016. Round 1 2017 will take place in the same nine Metropolitan Service Areas (MSAs) as the Round 1 Recompete; however, due to changes in the program and zip code updates the nine MSAs now break down into 13 Competitive Bidding Areas. Those CBAs are...
When repairing patient owned equipment, in the event that a repair takes longer than one day to complete, there may be instances when a supplier will need to provide temporary replacement equipment (i.e. loaner equipment). Suppliers commonly struggle with how to bill for this “loaner” or “temporary replacement” equipment while performing repairs. With HCPCS K0462 (temporary replacement equipment) one unit of service is equal to one month of rental. The date of service billed for the loaner equipment must be the date that it is delivered to the patient and must be billed on the same claim as the repairs. Keep in mind that when billing for loaner equipment you must include the following information in the NTE (narrative) segment of the claim:..
In December of 2014, suppliers were alerted that the new national RAC contract for DMEPOS, Home Health and Hospice had been awarded to Connolly, LLC (currently serving as the Jurisdiction C RAC). However, a protest to dispute the contract was filed with the Government Accountability Office (GAO) by the current Jurisdiction A RAC, Performant Recovery Inc. This protest essentially stalled CMS from proceeding with next steps until a decision was reached by the GAO.
While CMS has not directly addressed the status of these bid protests, a search of the GAO bid protest docket shows a total of two bid protests filed by Performant Recovery Inc. The first, B-410999.1 was filed on January 6, 2015 and the second B-410999.2 was filed on February 17, 2015. Both cases have been decided as of February 23, 2015 and are listed with an outcome of dismissed.