LAFAYETTE, La., May 16, 2022 (GLOBE NEWSWIRE) -- Viemed Healthcare, Inc. (the “Company” or “Viemed”) (NASDAQ:VMD and TSX:VMD.TO), a home medical equipment supplier and the nation’s largest independent provider of ventilation that provides post-acute respiratory care services, is providing an update concerning the Company’s appeal of claims related to findings from the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) in a May 2021 report (“Report”). Based on an objective and independent review of patients’ medical records, the Centers for Medicare and Medicaid Services’ (“CMS”) Qualified Independent Contractor (“QIC”) responsible for evaluating the Company’s Reconsideration appeals determined that approximately 77% of the claims it reviewed were medically necessary and properly payable under Medicare rules and regulations, overturning OIG’s and CMS’s initial recommendations and determinations.
“The success of our latest round of appeals is an extremely positive development for patients and their families who depend on payors to hold up their end of the health care delivery network,” said Casey Hoyt, Viemed’s CEO. “We wholeheartedly believe in protecting and advancing the rights of these patients to have access to the care prescribed by qualified licensed physicians. As a leader in the respiratory care industry, we will continue to support responsible rulemaking and other initiatives to ensure that the best care remains available to those in need.”
In its Report, the OIG alleged that 98% of sampled claims in an audit of the Company’s non-invasive ventilation patients did not comply with Medicare requirements and recommended that CMS recoup funds. Through the statutory appeals process, the Company filed its Reconsideration appeals to the QIC in November 2021 seeking an objective and independent review of the OIG and CMS findings.
Because the initial overpayment determinations utilized OIG’s statistical extrapolation based on a 98% failure rate, the QIC’s decisions stated that any remaining overpayment amounts will need to be recalculated. While the results of the latest appeals significantly reduce the range of possible losses for Viemed, the Company awaits communication of recalculated overpayment amounts, which may require further appeals.