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

Overview of Federal Statutes and Regulations Governing Medicare Advantage Plans and Medicaid Managed Care Plans

December 4, 2021
AMARILLO, TX – Federal statutes and regulations governing Medicare Advantage and Medicaid Managed Care organizations are quite extensive. However, only a small portion of the regulations govern the relationship between the organizations and the

Cash Sales and HIPAA: Avoidance of Pitfalls

November 5, 2021
AMARILLO, TX – Increasingly, DME suppliers are seeking to diversify their income stream by selling products for cash. Assume that XYZ Medical, Inc. has a PTAN and its principal business is to provide Medicare-covered items on an assigned basis.

Compensation to Physicians: Federal and State Kickback Implications

October 10, 2021
AMARILLO, TX – In an Oct 2020 press release, the Department of Justice (DOJ) announced a federal False Claims Act (FCA) settlement with Utah-based Merit Medical Systems, Inc. The press release says, in part: Medical device maker Merit Medical S