Suppliers with insurance contracts need to understand how those contracts impact cash sale transactions. To help suppliers avoid legal landmines while navigating the DME cash-pay landscape, health law attorneys Jeffrey Baird and Lisa Smith presented a free webinar on August 2, 2017. Set out below are select questions and Brown & Fortunato’s answers, as well […]
(May 2013) The DME industry justifiably feels like it is under siege. The industry, in its present form, has been around for about 35 years. Compare this to physicians, pharmacists and hospitals that have been around for thousands of years. The DME industry grew up unregulated. HCFA (now CMS) barely knew that we existed. The […]
(September 2012) In a 2008 Advisory Opinion, the OIG addressed a proposed arrangement in which a DMEPOS company would have personnel on-site at hospitals to train and educate patients that had been prescribed a product and had selected the company as his or her supplier.[ OIG Advisory Opinion No. 08-20.] The hospitals would provide a […]
(August 2012) There are a number of federal statutes and regulations that govern HME suppliers. In particular, suppliers need to be aware of the “big four”: Medicare anti-kickback statute; telephone solicitation statute; beneficiary inducement statute; and the supplier standards. While these statutes and standards clearly apply to Medicare fee-for-service patients, the following question often arises: […]
(April 2012) Not too many years ago, an HME provider was not vulnerable to scrutiny from many people/agencies. A DMERC (now a DME MAC) may look at some claims on a post-payment basis. An NSC inspector would show up every couple of years to make sure that hours are posted and the provider has insurance. […]
(March 2012) Question: In addition to being besieged by Medicare prepayment reviews and post-payment audits, I am seeing an increase in activity by state Medicaid programs. What is going on? Answer: With 78 million “baby boomers” retiring at the rate of 10,000 per day, Medicare will continue to be a pivotal part of our nation’s […]
(April 2011) Question I keep hearing about call centers. What exactly is a call center? Answer A call center can be internal or external. Let’s say that ABC Medical, Inc. is a mail-order supplier of diabetic testing supplies. ABC may have a group of employees who take up 1000 square feet. This group of employees […]
