Durable Medical Equipment (DME) Providers

The Law

Attention to detail through the entire process of offering Durable Medical Equipment Prosthetics & Orthotics Supplies (“DMEPOS”) to Medicare beneficiaries is of the utmost importance. Incorrectly filling out the state licensure application or Medicare Part B Enrollment Application can result in delays in processing your application, and could ultimately result in the denial of your application. Intentionally providing false or misleading information any enrollment application can subject the applicant to a variety of civil and/or criminal penalties. Additionally, depending on the specifics pertaining to your practice setting and services being offered, there may be a variety of other Federal and State regulations that may have to be considered (Stark, Anti-Kickback, etc.).

Articles from Our Team

People looking to enter the direct-to-consumer medical supply business often question whether becoming a pharmacy or durable medical equipment provider (DME) is a “better” endeavor. Now, more than ever, due to industry changes and because of the synergies between the two, the answer is “ become both.” Think about it. Read on

The indictments and regulatory activities that took place on April 9th were just the tip of the iceberg when it comes to the crackdown on DME fraud, telemarketing and telemedicine operations. In the weeks and months that have followed ‘Operation Brace Yourself’, healthcare providers (such as DME suppliers and telehealth physicians)

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Receiving an audit from a PBM’s senior investigator or its Fraud Waste & Abuse (“FWA”) Department is typically a sign that a pharmacy is being closely scrutinized. Such audits may focus further on co-pay collection, and may require that the pharmacy’s drug wholesalers submit proof of purchase documentation directly to the PBM to evidence the pharmacy had the inventory of drugs it had submitted claims for. Sometimes the PBM will even reach out to the physician indicated on the prescription to confirm the authenticity thereof. These PBM auditing techniques are ripe with issues and commonly create confusion for the wholesalers and prescribers. This results all too often with inaccurate discrepancy reports being issued by the PBM requesting or offsetting monies that it is not entitled to. Read on

Come January 2021, if a DME provider has not been awarded a CMS contract to supply a competitively bid item to a Medicare beneficiary that resides in a competitive bid area it will be unable to do so. Suppliers looking to participate in the latest rendition of CMS’ Competitive Bidding Program need

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WHO (does it impact)?

Any Medicare enrolled DMEPOS supplier that desires to service a Medicare Part B beneficiary with any medical equipment or device that is included in Medicare’s Competitive Bidding Program. WHAT (is competitive bidding and what DMEPOS supplies are covered)? In a nutshell, it’s essentially this: if a DMEPOS supplier

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Stay proactive and keep yourself out of hot water. Being prepared, asking questions and staying up-to-date on changes in the DME world will help your business stay compliant. Our industry expert roundtable of healthcare lawyers are here for you. Just send us a message and we will get back to you.

Follow real-time DME provider news updates.

Videos

Always stay up-to-date with DMEPOS provider tips with healthcare lawyer Michael Silverman. Michael provides real-time updates and webinars on what to do when you’re a DMEPOS business owner, or if you’re looking to purchase one. View the DMEPOS video library.

How we Help

Whether its navigating increasingly complex regulations to become a new provider, assisting with competitive bidding, or fighting licensure or audit activity in an existing DME business, The Florida Healthcare Law Firm is uniquely positioned to help your DME business with all of its regulatory and operational needs.

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