CMS Guidance: Shipping and Billing CGM Refills Before Date of Service

March 27, 2021
AMARILLO, TX – Determining the date of service (“DOS”) for DME is dependent on the type of delivery method utilized. The DOS for DME delivered in-person to a beneficiary is the date the beneficiary received the DME. If the DME is mailed or

Out-of-Network Supplier: Waiving Copayment

March 20, 2021
AMARILLO, TX – Historically, DME suppliers 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 Medicai

Stark and the In-Office Ancillary Services Exception

March 13, 2021
AMARILLO, TX – There are a number of federal anti-fraud laws that DME suppliers need to be aware of. Two of the most important federal laws are the anti-kickback statute (“AKS”) and the physician self-referral statute (“Stark”). The AKS

Changes to Stark and the Anti-Kickback Statute – Part Three

March 6, 2021
AMARILLO, TX – Historically, health care in the United States has been based on fee-for-service (FFS). That is, third party payors (TPPs) pay a physician, hospital or other provider for the service rendered…regardless of the outcome. A by

Changes to Stark and the Anti-Kickback Statute – Part 2

February 27, 2021
AMARILLO, TX – Historically, health care in the United States has been based on fee-for-service (FFS). That is, third party payors (TPPs) pay a physician, hospital or other provider for the service rendered…regardless of the outcome. A by

Changes to Stark and Anti-Kickback Statute – Part 1

February 20, 2021
AMARILLO, TX – Historically, health care in the United States has been based on fee-for-service (“FFS”). That is, third party payors (“TPPs”) pay a physician, hospital or other provider for the service rendered…regardless of the o