AMARILLO, TX – Historically, DME suppliers have taken care of Medicare patients and have billed CMS directly. This is known as “Medicare fee-for-service” (or “Medicare FFS”). Also, historically, suppliers have taken care of state Medicaid patients and have billed state Medicaid programs directly (“Medicaid FFS”). All of this is changing. Today, about 47% of Medicare patients are covered by Medicare Managed Care Plans (commonly known as “Medicare Advantage Plans”) and about 70% of Medicaid patients are covered by Medicaid Managed Care Plans. These percentages are increasing.

GOOSE CREEK, SC – Industry legend Sheldon “Shelly” Prial died last month at the age of 95. Shelly’s passion, knowledge, and willingness to fight for...

ATLANTA – Medtrade West wrapped at the Phoenix Convention Center earlier this year, and show organizers are now putting their full attention on Medtrade East, scheduled for Oct. 24-26, 2022 at the Georgia World Congress Center in Atlanta.

AMARILLO, TX – All health care providers, including DME suppliers, should be aware of the federal anti-kickback statute (“AKS”). It is a criminal statute. The AKS prohibits a DME supplier from paying (or offering to pay) or receiving (or asking to receive) anything of value in exchange for (i) the referral of a patient covered by a federal health care program (“FHCP”), (ii) arranging for the referral of an FHCP patient, or (iii) recommending the purchase of a product or service covered by an FHCP. A number of federal circuits have adopted the “one purpose” test. This states that if one purpose behind paying a party is to reward the party for referrals, then the AKS is violated notwithstanding that the principal purpose behind the payments is to pay for legitimate services.

NEW YORK, N.Y. – Vijay Kedar, co-founder and CEO of New York-based Tomorrow Health created the company as a way to enable seamless collaboration between suppliers, payers, and referring providers—fulfilling the goal of delivering high-value care where patients want it most—in the home.

AUCKLAND, NZ – Fisher & Paykel Healthcare Corporation Limited has selected Tracey Barron to participate in the Future Directors programme, effective June 1. Barron has more than 25 years of experience across a broad range of health-related roles. This includes working for the Southern Cross Group in a range of capacities, including most recently as chief of strategy for Southern Cross Healthcare. Barron has previously also held management roles with the Counties Manukau District Health Board, the Ministry of Health and Pharmac, and has been a director of a number of health care businesses.

LOVELAND, CO – For more than a dozen years, Medtrade Monday has had the opportunity to run what has likely been hundreds of articles about Medicare...