Contracting with Medicare Advantage Plans

October 24, 2025

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

October 16, 2025

DME suppliers must not only satisfy traditional Medicare FFS requirements, but they must also satisfy Medicare Advantage Plans (MAPs).

Study Quantifies Claim Denials

October 10, 2025

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

October 10, 2025

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

October 3, 2025

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.

Legal Challenges Facing DME

September 28, 2025

DME suppliers are highly regulated and scrutinized. A goal of Federal laws is to protect taxpayer money from fraud.