melodie, Author at Brown & Fortunato

Yes, You Can Call Medicare Beneficiaries…But Be Careful

(July 2013) Let me make this clear: CMS does not like it when DME suppliers call Medicare beneficiaries. A CMS official once said to me: “We don’t want DME suppliers calling our beneficiaries.” The concern is that an elderly person….who does not feel well…..can be taken advantage of over the phone by an unscrupulous supplier […] More...

Purchasing A DME Supplier: The Importance Of Regulatory Due Diligence

(June 2013) Introduction It has been the goal of entrepreneurs over the centuries: start-up business, build the business up, and sell it for a profit. This has been the cycle in the restaurant industry, the sporting goods industry, and the DME industry. Because of the “perfect storm” of competitive bidding, post-payment audits, prepayment reviews, and […] More...

Grandfathering: Reimbursement And Legal Pitfalls

(May 2013) With competitive bidding scheduled to go into effect on July 1, “grandfathering” has taken center stage. This article addresses two key grandfathering issues. The first is the reimbursement that the grandfathered supplier will receive. The second is a potential legal pitfall that suppliers should strive to avoid. What Items Are Grandfathered In? The […] More...

Competitive Bidding: More On Asset Purchases And Subcontracting

(May 2013) Introduction The competitive bidding program is not based in reality. It is forcing suppliers to “pound square pegs into round holes” and is forcing suppliers to enter “shotgun marriages.” However, I know that I am preaching to the choir. Competitive bidding is forcing a large number of DME suppliers to engage in asset […] More...

Subcontract Agreement: Hot Button Issues In The Competitive Bid Arena

(April 2013) CMS announced the final rule for competitive bidding on April 10, 2007. [CMS, Competitive Bidding, 72 Fed. Reg. 17992 (Apr. 10, 2007).] In the final rule, CMS indicated that contract suppliers may subcontract with non-contract suppliers as long as the subcontractor has not been “excluded from the Medicare program, any State health program […] More...

Joint Ventures And Other Arrangements Between HME Suppliers And Hospitals

(July 2012) Approximately 15 years ago, it was not uncommon for hospitals to own their own HME operations. Approximately eight years ago, many of these hospitals shut down their HME operations. The hospitals realized that running an HME business was a “totally different animal” from running a hospital. Basically, the hospitals were losing money on […] More...

Sharing of Space With Another Provider: What You Can And Cannot Do

(July 2012) In the real world, one business can share physical space with another. For example, Schlotzsky’s can share space with Cinnabon, truck stops can share spaces with fast food outlets, and so on. Unfortunately, HME suppliers are not in the real world. They live in Alice in Wonderland where up is down, down is […] More...

The CEO Should Not Serve As The Provider’s Compliance Officer

(June 2012) There is not a great deal of formal guidance concerning the choice of a compliance officer. The Federal Sentencing Guidelines Manual states that “high-level personnel” should have overall responsibility for the compliance program, but makes no recommendations about what positions may appropriately be combined with the compliance officer role. The Office of Inspector […] More...

Creating Effective Corporate Compliance Plan, Policies, And Procedures

(April 2012) CEOS – COMPLIANCE STARTS AT THE TOP An effective compliance program requires commitment, leadership and resources from the governing board, the CEO and senior management, and this program is intended for senior leaders of HME supplier entities. Learn why an effective compliance program helps create financial success, customer loyalty, community support and employee […] More...

Federal E-Sign Act: What It Means For The HME Provider

(May 2012) The signature of the Medicare beneficiary is important. The HME provider needs the beneficiary’s signature on an AOB. Before an HME provider calls a prospective customer, the provider needs the beneficiary’s written permission. And the list goes on. Fortunately, technology and a federal statute have intervened to make it easier for the provider […] More...