Fraud and Abuse Laws: Cliffs Notes Version

January 18, 2020
AMARILLO, TX – DME suppliers operate in a highly regulated environment. Suppliers must comply with (i) federal anti-fraud laws, (ii) state anti-fraud laws, (iii) supplier standards, (iv) accreditation requirements, and (v) guidance from Medicar

Accessing Another Supplier’s Commercial Insurance Contract

January 4, 2020
AMARILLO, TX – Approximately (i) 35% of all Medicare patients are covered by Medicare Advantage Plans (“MAPs”) and (ii) 70% of all state Medicaid patients are covered by Medicaid Managed Care Plans (“MMCPs”). These percentages are incre

Lab Kickback Settlement: Lessons for DME Suppliers

December 29, 2019
AMARILLO, TX – According to a recent Department of Justice (“DOJ”) Press Release, Boston Heart Diagnostics Corporation (“BHDC”), a Framingham, MA lab, has agreed to pay $26.67 million to resolve False Claims Act (“FCA”) allegations

Cannabidiol (“CBD”): A Primer – Part 2

December 13, 2019
AMARILLO, TX – As I mentioned in last week’s Part One, this may seem like a strange article to write for DME suppliers. However, an increasing number of DME suppliers (like pharmacies, health food stores, and others) are looking at the potent

Audit Liability Following Sale

December 1, 2019
AMARILLO, TX – Two questions that are often asked: “If I sell my business, can I still get audited? If I do get audited after selling my business, do I have personal liability?” Asset Sale Assume that John Smith owns ABC Medical Equipment,

Billing Non-Assigned: Additional Information

November 23, 2019
AMARILLO, TX – For the last four decades, DME suppliers have primarily provided DME on an assigned basis. Medicare paid the suppliers directly and the patients only had to pay their copayments and deductibles. Until approximately 2010, this wor