Moving the Needle on Audits

August 31, 2015
WASHINGTON, DC – The industry must be able to demonstrate the burdensome nature of audits, both in terms of volumes and overturn rates. If we cannot accurately detail how the industry is being impacted, we will not be able to succeed in obtaini

CMS Limits Scope of Review on Redetermination and Reconsideration

August 24, 2015
AMARILLO, TX – One of the most difficult and frustrating aspects of being a DME supplier is dealing with Medicare post-payment reviews, audits and overpayment determinations. The experience of a large audit can be daunting and expensive. &n

Beneficiary Inducement Statute – Applicability to DME Suppliers

August 17, 2015
AMARILLO, TX – It is a common business practice in the non-health care world for a retailer to offer free products and services to customer and prospective customers. For example, Jos. A. Banks will advertise:  “Buy one suit and get

The 60-Day Rule – What Does it Mean?

August 10, 2015
AMARILLO, TX – Under the Affordable Care Act, a person or entity that has received a payment from a Medicare or Medicaid program to which the person or entity is not entitled (i.e., an overpayment) is obligated to refund the overpayment to the

Know Your Vulnerabilities

August 3, 2015
ATLANTA – There is simply no way to avoid a Medicare audit these days. Per data from Medicare, the volume of audits has increased from around 1,200 per week to approximately 15,000 per week.   It has simply become a normal part of doing bu

Recent Federal Cases – Medicare Anti-Kickback Statute

July 27, 2015
AMARILLO, TX – The Medicare anti-kickback statute makes it a felony to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce a person or entity to refer an individual for the furnishing or arranging for the furnishi