Questionable Actions by Medicare Advantage Insurers: The Dialogue Escalates

October 14, 2022

AMARILLO, TX - As discussed in previous Medtrade Monday articles, over the last 12 years, while the DME industry was focused on competitive bidding and aggressive audits, managed care snuck up on the industry through the back door.

60-Day Rule: Guidance for DME Suppliers

September 24, 2022

AMARILLO, TX - Years ago, when a DME supplier would determine that Medicare had previously paid claims to the supplier that the supplier should not have submitted, the supplier might have been inclined to “go and sin no more.”

Medicare Advantage Plans and Medicaid Managed Care Plans: Cliff’s Note Version

September 15, 2022

AMARILLO, TX - Previously, I wrote a series of articles addressing Medicare Advantage Plans and Medicaid Managed Care Plans. I have condensed the previous articles into a short (hopefully easy-to-read) Cliff’s Note version. 

Working with Lead Generation Companies

August 19, 2022

AMARILLO, TX - The Department of Justice (DOJ) and Office of Inspector General (OIG) are scrutinizing arrangements that health care providers and suppliers (pharmacies, labs, DME suppliers, etc.) have with lead generation companies (LGCs).

Re-Starting the 36-Month Oxygen Rental Period

July 29, 2022

A new 36-month rental period can begin only in the following situations: After the five year reasonable useful lifetime (“RUL”) of the oxygen equipment has expired, if the beneficiary elects to obtain new oxygen equipment.

Baird: Latest On Loan Closets

July 23, 2022

AMARILLO, TX - A “loan closet” is also known as a “stock and bill”...which is also known as a “consignment closet.” A DME supplier can set up a loan closet arrangement at a hospital, clinic, or physician’s office (“Facility”).