ALJ Backlog and AHA Case: Recent Court Ruling

November 24, 2018
AMARILLO, TX – The current administrative appeals process is beyond unfair to DME suppliers. A supplier will get hit with a post-payment audit involving multiple patients. The auditing contractor will look for reasons to deny the claims and see

Competitive Bidding on Hiatus: Operating in the “Gap Period”

October 20, 2018
AMARILLO, TX – From Day 1 of competitive bidding, the DME industry sounded the alarm that the program would be unworkable. Industry stakeholders pointed out: “Low ball bidders” would submit bids in multiple CBAs…with no ability to tak

Noridian, CGS and the “60 Day Rule”

October 13, 2018
This is a reprint of the article that was published in last week’s Medtrade Monday. Medtrade Monday and the two authors decided to run this article a second time because of the importance of the topic. Note that Jeff and Wayne will present a webina

Noridian, CGS, and the “60 Day Rule”

October 5, 2018
AMARILLO, TX – Section 6402 of the Affordable Care Act states that any provider or supplier that receives an overpayment must (i) report to CMS and (ii) provide written notice of the reason for the overpayment. The overpayment must be reported

Physician Arrangements and Accessing Third Party Payor Contracts

September 29, 2018
AMARILLO, TX – There are two recurring issues that DME suppliers face. The first issue pertains to the types of arrangements that suppliers can enter into with physicians. The second issue pertains to the situation in which Supplier A is a part

New Competitive Bidding Track at Medtrade Addresses Jan 1, 2019 Gap Period

September 23, 2018
ATLANTA – On Jan 1, 2019, any willing provider will be able to participate in the Medicare program, regardless of prior bidding “wins” or losses. What should providers do? Educational advisory board (EAB) members at Medtrade will outline all of