COMPLIANCE AND REGULATION
Oximetry and home sleep testing simplified.
Compliance and Regulation
As a member of the healthcare industry, like yourself, we understand the compliance issues you face and the scrutiny you are under to ensure that fraud and abuse is limited. To support your needs and concerns, we have designed this section to share methods and strategies focused on keeping your organization complaint and secure while using our services. Be sure to revisit this page occasionally as we will update it to keep up with changes in state and federal laws.
Independent Diagnostic Testing Facility (IDTF) – Performance Standards
Terms and Conditions
Your use of the Vitalistics™ website confirms your agreement to be bound by the following terms and conditions contained in this agreement as well as any rules for use of the services. It acts as your receipt and proof of understanding of the disclosures in this agreement, and also as an agreement allowing all disclosures or other information required under applicable law to be sent electronically. Except as otherwise required by rule, law, or regulation, we may change the terms and conditions of this agreement at any time, as needed. When changes are made, we will update this agreement on the website.
Changes will be effective when first updated on the website unless rules, laws or regulations require advanced notice in which case the change will be effective in accordance with the rule, law, or regulation. Unless otherwise required by applicable law, we have the right to terminate this agreement and/or your access to the Vitalistics software and/or service or Vitalistics website at any time, at our convenience and without cause. In no event will Vitalistics be liable for any direct or indirect, special, incidental, consequential, or punitive damages or lost profits arising in connection with use of our Vitalistics software and services, any interruption in availability of our Vitalistics website, delay in operation or transmission, computer virus, loss of data, or otherwise, even if Vitalistics has been advised of the possibility of such damages or loss.
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Medicare Information: Overnight Pulse Oximetry and Home Oxygen
Information from CMS
- Medicare Transmittal for Self-Administered Pulse Oximetry – This transmittal discusses how the Durable Medical Equipment (DME) Company can be a part of the oximetry testing for any patient.
- Medicare National Coverage Determinations Manual Chapter 1, Part 4 (Sections 200 – 310.1) Coverage Determinations, 240.2 – Home Use of Oxygen (Rev. 173, Issued: 09-04-14, Effective: Upon Implementation: of ICD-10, Implementation: Upon Implementation of ICD-10)
- Medicare Program Integrity Manual, Chapter 5 – Items and Services Having Special DME,Review Considerations
- Certificate of Medical Necessity – Oxygen DME 484.03 – This is the form that must be used starting January 1, 2007.
- Home Oxygen Therapy Booklet – Centers for Medicare & Medicaid / Text only booklet – This booklet is designed to provide education on the coverage of home oxygen therapy under the Medicare Program. It includes the following information: covered oxygen items and equipment for home use; coverage requirements; criteria you must meet to furnish oxygen items and equipment for home use; Advance Beneficiary Notice of Noncoverage; oxygen equipment, items, and services that are not covered; payments for oxygen items and equipment; billing and coding guidelines; and resources.
- Changes in Medicare Payment for Oxygen and Oxygen Equipment – This article alerts suppliers and providers that the Centers for Medicare & Medicaid Services (CMS) is implementing new oxygen payment rules and supplier responsibilities as a result of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) in the Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2009 as displayed in the Federal Register on October 30, 2008. These changes are effective for services provided on or after January 1, 2009. Be sure billing staff are aware of these changes.
- Coverage Issues – Durable Medical Equipment, 60-4 Home Use of Oxygen – Manual section detailing the changes to the coverage for home use of oxygen.
- “Mining” for Patients: Be Aware of Legal Pitfalls, by Jeffrey S. Baird, JD, 10/21/2012 22:34 – Suppliers need to clearly understand the concerns and prohibitions that the OIG, CMS and DME MACs have about DME suppliers “mining” for patients, and the risks associated with such activities.