There have been some long faces around our conference room table over the past few months. Several large payers have done their homework, and come to realize that chiropractic and physician practices need home medical equipment licenses in order to sell T.E.N.S. units. We are starting to see claims for T.E.N.S. units being challenged, and ultimately rejected, with the explanation that the practice fulfilling the order lacks the required license.
In Florida, any person or entity that holds itself out to the public as providing home medical equipment (“HME”) that typically requires home medical services must be licensed by the Agency for Health Care Administration. (FL Statute §400.93). The statute has two requirements: the item must be HME and it must be the sort that requires services. Most of us would guess that T.E.N.S. units are HME, and we would be correct. Since T.E.N.S. units are reimbursed under Medicare Part B as durable medical equipment, they are HME under Florida law. (FL Statute §400.925(6)). Less intuitive is the notion that a T.E.N.S. unit is a product that typically requires home medical services; after all, most patients can use the unit effectively and properly after just a few moments of in-office instruction. Well, as a matter of Florida law, T.E.N.S. units are deemed to be equipment requiring services (FL Administrative Code §59A-25.003(2)(b)). So, if you sell T.E.N.S. units in Florida, you ought to have a home medical equipment provider's license.
Licensure is required to sell T.E.N.S. units, but not to use them on patients in the course of your practice. (FL Statute §400.93(5)(i)).
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Mr. Hirshfeld has dedicated the majority of his 18 year legal career to a strong focus on the healthcare industry and has an exceptional reputation as a corporate attorney. He has structured, negotiated and documented many business transactions which include a variety of issues involving compliance; business planning through growth, succession and exit strategies, governance, control and operational issues; and the impact of state and Federal legislation including anti-self-referral (e.g. "Stark"), anti-kickback and corporate practice of medicine laws; professional misconduct; managed care contracting guidelines; Medicare; HIPAA and tax laws. He can be reached at david@floridahealthcarelawfirm.com or 888-455-7702
