Products Added to Face-to-Face Encounter and WOPD List and Required Prior Authorization List

January 21, 2022
WASHINGTON, DC – On January 13, 2022, CMS published the HCPCS codes that will be added to the list of products that require a face-to-face encounter and written order prior to delivery (WOPD) as well as the HCPCS codes added to the list of prod

Rights of a DME Supplier Under a Medicare Advantage Plan

January 15, 2022
AMARILLO, TX – This article discusses the federal laws that address the steps a DME supplier can take when it concludes that a Medicare Advantage Plan (MAP) is taking steps that violate the contract between the supplier and the MAP, or steps th

The No Surprises Act’s New Requirements and Prohibitions in Patient Billing

January 1, 2022
AMARILLO, TX – Starting January 1, 2022, one of the most extensive consumer/patient protection laws in health care since the Affordable Care Act will take effect. On the first day of the new year, health care providers and commercial insurance

Medicaid Managed Care Plans: Access to Care Requirements

December 24, 2021
AMARILLO, TX – We are writing a series of Medtrade Monday articles addressing federal law pertaining to Medicare Advantage Plans (MAPs) and Medicaid Managed Care Plans (MMCPs). The previous three articles (i) presented an overview of federal la

Medicare Advantage Plans: Access to Care Requirements

December 18, 2021
AMARILLO, TX – We are writing a series of Medtrade Monday articles addressing federal law pertaining to Medicare Advantage Plans (MAPs) and Medicaid Managed Care Plans (MMCPs). The previous two articles (i) presented an overview of federal laws

Medicare Advantage Plans and Medicaid Managed Care Plans: Minimum Level of Service

December 11, 2021
AMARILLO, TX – This article summarizes the federal laws that address the minimum level of services that a (i) Medicare Advantage Plan (“MAP”) must provide to enrollees and (ii) Medicaid Managed Care Plan (“MMCP”) must provide to enrolle