Entering Into a Properly Structured Medical Director Agreement

April 7, 2014
AMARILLO, TX – Under the Medicare anti-kickback statute, it is a felony for DME suppliers to knowingly or willfully offer or pay any remuneration to induce a person to refer a person for the furnishing, or arranging for the furnishing, of any i

DME MAC Instructions to Physicians – Detecting Scams

March 31, 2014
AMARILLO, TX – When it comes to fraud enforcement, the real power is with the Medicare contractors: DME MACs, ZPICs, the NSC, and even the accrediting organizations. Certainly, the Department of Justice, with the help of the Office of Inspector

Diabetes Test Strips in the Spotlight

March 24, 2014
AMARILLO, TX – Anytime the OIG takes the time to shine a “spotlight” on something, it is important to take notice. From time to time, the OIG publishes “Spotlight Articles,” which address certain programs, practices, and products that h

Preparing for and Responding to Audits – A Primer

March 17, 2014
AMARILLO, TX – The Medicare fee-for-service program receives over 1.2 billion claims per year: (i) 4.5 million claims per work day; (ii) 574,000 claims per hour; and (iii) 9,579 claims per minute. From 2010 to 2013 OHMA claims and entitlement w

Audits on the Brain – van Halem Addresses Concerns at Medtrade Spring

March 17, 2014
LAS VEGAS – Onerous audits have plagued a huge percentage of HME providers in recent years, and unfortunately the audit tempo shows no sign of slowing. According to Wayne van Halem (pictured), president of the van Halem Group LLC, the future holds,

Change is on the Horizon – CMS is Soliciting Comments on its Payment Methodology

March 3, 2014
AMARILLO, TX – You have heard since the beginning of the competitive bidding program that eventually the single payment amounts would have an effect on areas that are not part of a competitive bidding area (CBA). That time is now. On February 2