Friday, August 31, 2007

Q. My Medicare supplier number has been revoked and I have requested an appeal. What do I need to do before the hearing?

A. If you are a supplier and you have just received a letter of revocation, indicating what supplier standard you have allegedly violated, you are entitled to request an appeal hearing. Prior to the hearing you have a right to review the evidence the government has against you.
Request the evidence
Please keep in mind that the government will not just volunteer information. If you have not hired legal counsel to handle your appeal (which we strongly advise against), then you need to be proactive in requesting that the hearing officer turn over all evidence.
Review the evidence
Once you have received the evidence, review the evidence. It is not uncommon to receive a pile of papers, which may detail specific Medicare transactions, but may not specify how the evidence relates, if at all, to your alleged violation of supplier standards. After reviewing the evidence, determine what you do and do not understand. If you do not understand the information the government is relying on for its case, you will be unable to provide an effective counterargument.
Respond to the evidence
If you still do not understand what you are being accused of, follow up with the hearing officer via a letter. If you can show that you were not clearly provided with all the evidence, this could help you during your hearing, or it could help you in any further appeal.
If you do understand the evidence, send the hearing officer a letter describing your interpretation of the evidence and the reasoning behind the actions you took. If the evidence clearly shows that you made a mistake, you may wish to include assurances that you will not make such a mistake again and have a corrective action plan.
Revocation can be a frightening time for any business owner, which is why you are always advised to seek counsel. But if you choose to fight on your own, at least ensure that you have seen the government's ammunition.
Brian Miller is an associate attorney at the Health Law Center. Reach him at 864-676-9075 or