Did CMS Miscalculate Proposed Rental Rates for CGMs and Insulin Pumps?
The error is related to the cumulative supply allowances embedded in the reimbursement rate.
Contracting with Medicare Advantage Plans
Medicare Advantage has increasingly been criticized for waste, fraud, and abuse. A key issue lies in how the government reimburses these private insurers.
Medicare Advantage: Negotiating Strategies and Securing Contracts
DME suppliers must not only satisfy traditional Medicare FFS requirements, but they must also satisfy Medicare Advantage Plans (MAPs).
Study Quantifies Claim Denials
Unlike large hospital systems that can better absorb administrative overhead, independent providers operate on razor-thin margins.
Subsidizing a Referral Source’s Expenses: Kickback Implications
The lesson for DME suppliers is that if they are going to provide services to a referral source, the referral source needs to pay FMV compensation to the suppliers.
Exceptions Under the Stark Law
There are many exceptions to Stark. If an arrangement meets an exception, Stark is not violated. The following are Stark exceptions applicable to DME suppliers.