A Scary New Trend: Six-Year Lookback Audits - HME Business

• California Home Medical Device Retail Exemptee Online Training Certification Course - accepted by the California Department of Public Health (Food and Drug Branch)

The full article is a must read:  A SCARY NEW TREND: SIX-YEAR LOOKBACK AUDITS - Understanding another 'new normal' for HMEs from HHS OIG. - HME Business

"The Office of Inspector General (OIG) regularly performs audits and reviews as part of its normal functions. In June 2018, it released a scathing report entitled, “Most Medicare Claims for Replacement Positive Airway Pressure Device Supplies Did Not Comply With Medicare Requirements.”"  ... 

"In layman’s terms, suppliers either have to review every claim they have submitted for PAP supplies for the previous six years, or they must identify the universe of claims by taking a statistically valid random sample and extrapolating the results of the audit once the sample has been reviewed. They are asking suppliers to do something that requires the high-level skills and knowledge of an expert statistician."

#HMDRexemptee #HMDR #HME #DME #CPAP

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California Home Medical Device Retail Exemptee Online Training Certification Course - accepted by the California Department of Public Health (Food and Drug Branch)

For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training  
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Examination Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

Most Medicare Claims for Replacement PAP Device Supplies Didn't Comply With Medicare Requirements - OIG

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California HMDR Exemptee Training Certification:

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

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Read the full June 2018 report:

Most Medicare Claims for Replacement Positive Airway Pressure Device Supplies Did Not Comply With Medicare Requirements - DHS OIG (PDF - click this link)

"Most Medicare claims that DME suppliers submitted for replacement PAP device supplies did not comply with Medicare requirements. Of the 110 claims in our sample, 24 complied with Medicare requirements; however, 86 claims with payments totaling $13,414 did not. On the basis of our sample results, we estimated that Medicare made overpayments of almost $631.3 million for replacement PAP device supply claims that did not meet Medicare requirements."

The CMS expressed interest in educating health care providers on avoiding Medicare billing errors.

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Training for HMDR Exemptee license applicants - Earn a course completion certificate - Accepted by the California Dept of Public Health (CDPH)

For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training - New!
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Exam Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

CMS revamps claims review process | HME News

Read the full article: CMS revamps claims review process | HME News:

"Claims submitted by providers that have the highest claim error rates or billing practices that vary significantly from their peers will soon face increased scrutiny, CMS has announced.

As part of an expanding “Targeted Probe and Educate” program, the Medicare Administrative Contractors will identify these providers through data analysis."

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Training program for California Home Medical Device Retailer (HMDR) license applicants - Earn a completion certificate

For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training  
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Examination Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

Hackers in no rush to cash in on stolen data | Health Data Management

Updated November 22, 2025

The original link broke.

You can still read about the same topic here:

Hackers in no rush to cash in on stolen data - seclists.org

---  the original post follows below  ---

Read the full article: Hackers in no rush to cash in on stolen data | Health Data Management:

"That hacker, Hepp says, is using the data to generate false claims for durable medical equipment, hospice or home health services not being delivered. “Stealing data means you don’t have to find patients; you just make up new patients,” she says."

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Training for HMDR Exemptee license applicants

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For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training  
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Examination Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

Big Data Tool Saves CMS $1.5B by Preventing Medicare Fraud - RevCycle Intelligence

• Enroll now to take this California Exemptee Training Certification Course - for home medical device retailers (HMDR)

Updated February 2, 2026

The original link broke.

You can still read about the same topic here:

‘Big data’ effort saves $1.5B in Medicare fraud - Healthcare Dive:

https://www.healthcaredive.com/news/big-data-effort-saves-15b-in-medicare-fraud/419996/

--   the original post follows below  ---

Read the full article: Big Data Tool Saves CMS $1.5B by Preventing Medicare Fraud - RevCycle Intelligence:

"Using big data tools and predictive analytics, the Centers for Medicare and Medicaid Services (CMS) has saved approximately $1.5 billion by preventing Medicare fraud in the traditional fee-for-service program, according to the official CMS blog.

Since June 2011, CMS has employed the Fraud Prevention System, which is a predictive analytics tool that identifies fraudulent claims and illegitimate Medicare payments. The tool analyzes about 4.5 million Medicare pre-paid claims each day to pinpoint potential issues before providers are paid."

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Enroll now to take this California Exemptee Training Certification Course - for home medical device retailers (HMDR)

For Designated Representative license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training affidavit):

• CA Designated Representative Wholesaler Training - Available around-the-clock 24 x 7
• CA Designated Representative 3PL Training
• CA Designated Representative Reverse Distributor Training  
• The Designated Representative Institute

     Florida:

• Florida Certified Designated Representative - CDR Laws and Rules Examination Prep Course

For HMDR Exemptee license applicants  -  Training programs, courses, classes, seminars:

     California (earn a training completion certificate):

• CA Home Medical Device Retailer (HMDR) Exemptee Training Course
• The Exemptee Institute

HME Audit Key data provides first look at severity of audits | HME News

Read the full article: Tool provides first look at severity of audits | HME News:

"Nationwide, 78% of providers appealed denials, with O&P leading the way with a 98% appeal rate, followed by ostomy, urological and wound care supplies at 87%.

Upon review, 60% of claims for hospital beds, support surfaces and manual wheelchairs were paid. For O&P and respiratory equipment, 15% and 74%, respectively were paid."

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CA HMDR Exemptee online internet-based training certification by SkillsPlus Intl Inc.
The Exemptee Institute

NEW! CA Designated Representative-3PL online training certification by SkillsPlus Intl Inc.- We'll send you the 3PL training affidavit upon successful course completion.
CA Designated Representative online web-based training certification by SkillsPlus Intl Inc. - Available around-the-clock 24 x 7
FL Certified Designated Representative (CDR) online exam prep course - Lots of practice exams - Practice makes perfect!
The Designated Representative Institute