Tag: Brown & Fortunato

AMARILLO, Texas - Brown & Fortunato has released a new white paper to help HME providers develop written guidance on protecting patients and employees under the challenging conditions of the current public health emergency. “Structuring COVID-19 Protocols for DME Suppliers” emphasizes the need to use reliable sources for structuring protocols and outlines major subject areas that should be covered. It joins other papers published by Brown & Fortunato, including “COVID-19 Personnel...

Historically, Medicare payments for health care have been based on the fee-for-service (FFS) model—that is, Medicare pays for the service regardless of the patient outcome. This model results in (i) providers not coordinating with each other and (ii) expenditure of money without evidence of tangible results. With 78 million baby boomers retiring at the rate of 10,000 per day, the FFS model is not sustainable. As such, Medicare is pushing providers away from the FFS model…and toward the collaborative...

LAS VEGAS - Now that Medicare and Medicaid are turning to managed care organizations (MCOs) more and more to cut costs, HME providers must be vigilant to make sure they get a fair deal, says Pam Colbert, an attorney with Brown & Fortunato. HME News recently spoke with Colbert, who is hosting two sessions at Medtrade Spring this year related to MCOs, about what providers need to know to play ball in this market and how to get paid.HME News: What are we dealing with here: How many Medicare and Medicaid...

WASHINGTON - As HME industry stakeholders work with CMS officials to shape future rounds of competitive bidding, they're focusing, first, on helping the agency re-arrange the program's product categories.Under lead-item pricing—where payment levels for the item with the highest expenditures in a product category determine the payment levels for all other items in the category—stakeholders say it doesn't make sense, for example, to bundle oxygen concentrators and CPAP devices in a broad...

ATLANTA - Medtrade has added a track called “The New Competitive Bidding” to its educational lineup, in response to a recent proposed rule that would allow any Medicare-enrolled provider to supply DME to beneficiaries starting Jan. 1, 2019. “If you are considering a dive back into Medicare when the gap period starts, Medtrade is the ideal place to learn literally everything about your options,” said Kevin Gaffney, group show director. The track will address: a historical view...

AMARILLO, Texas - Brown & Fortunato has added Markus Cicka and Beth Anne Jackson as its two newest shareholders, bringing its total number of health law attorneys to 17, according to an announcement. Cicka has 25 years of healthcare law under his belt, including as partner at two national law firms and as an in-house compliance officer and director for a state Medicaid program integrity unit. He is admitted to practice in Texas, Missouri and Illinois. Jackson has more than 21 years of experience...

WASHINGTON - AAHomecare has retained Brown & Fortunato to provide a range of legal and advisory services. Long-time HME industry advocate Cara Bachenheimer, who is set to open a Washington, D.C., lobbying office for the Amarillo, Texas-based law firm in June, will take the lead role representing the association's regulatory and legislative priorities. “I have had a front-row view of Cara's work on HME public policy issues over the years, and I have always come away impressed by her depth of...

A.  There is a good chance the prescription issued will not be valid, and the payment for the telehealth encounter could be problematic under an anti-kickback statute.      In order for a prescribing practitioner, such as a physician, physician assistant, or nurse practitioner, to issue a valid prescription, the practitioner must first establish a practitioner-patient relationship. Most states now allow a practitioner to establish this relationship by way of a telehealth...

A.  It depends on how the item will be paid for and where the patient lives, but for most patients this would not be acceptable.The Federal Anti-Kickback Statute (AKS) prohibits a supplier from giving a person something of value to induce the person to purchase an item covered by a federal health care program. Most states have similar laws, and some states have an AKS that applies regardless of how the item is being paid for (e.g., Medicaid, commercial insurance, cash). Paying for the cost of...

WASHINGTON ­- Cara Bachenheimer has a new gig that allows her to double-down on her efforts advocating for the HME industry.Bachenheimer is opening a Washington, D.C., office for Amarillo, Texas-based law firm Brown & Fortunato on June 1, a move that will expand her legislative and regulatory work beyond Invacare, where she has worked for more than 14 years.Here's what Bachenheimer, who will count Invacare as her first client, had to say about why lobbying is more important than ever before.HME News:...