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Tag: Polsinelli


Editorial

Bid reform: Options, opportunities

April 24, 2017Guest Commentary

The DMEPOS competitive bidding program has a long and controversial history; at this point, however, the program appears to be well-cemented into the fabric of the industry. Reports of abuse of the bidding process continue to rise with each new bid submission, including, among others, suppliers with little to no experience in certain product categories winning large competitive bid territories—territories that they have never served previously. The Trump Administration and Health and Human...

competitive bidding program, Home Medical Equipment, Polsinelli


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Guest Blog

Competitive bid program reform options and opportunities

March 22, 2017HME News Staff

The DMEPOS competitive bidding program has a long and controversial history; at this point, however, the program appears to be well-cemented into the fabric of the industry. Reports of abuse of the bidding process continue to rise with each new bid submission, including, among others, suppliers with little to no experience in certain product categories winning large competitive bid territories—territories that they have never served previously. The Trump Administration and Health and Human...

competitive bidding, Polsinelli


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Smart Talk

ALJ Appeals: Pay attention to details

January 3, 2017R. Ross Burris

A. If CMS or a supplier disagrees with an Administrative Law Judge's (ALJ) decision, the matter may be appealed to the Departmental Appeals Board (DAB). But, as many suppliers know, the DAB appellate process is substantially backlogged, although it is not as backlogged as the Office of Medicare Hearings and Appeals. This article will focus on tips and tricks designed to help the DAB efficiently dispose of your matter and render a quick decision (hopefully in your favor).Make the decision easyMaking...

ALJ appeals, Polsinelli, R. Ross Burris


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Smart Talk

ALJ Appeals: Be prepared from the start

November 30, 2016R. Ross Burris

A. A supplier that disagrees with a Qualified Independent Contractor's reconsideration decision is entitled to a hearing before an administrative law judge. But, an ALJ will not review new evidence—evidence that was not presented during previous levels of appeal without the supplier presenting “good cause.” The ALJ will not review any new evidence unless that evidence was unavailable or unknown at the time of the determination.Oftentimes, suppliers rely on the documentation submitted...

ALJ appeals, Polsinelli, Ross Burris


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Smart Talk

ALJ Appeals: Pay attention to details

September 29, 2016R. Ross Burris

A. A home medical equipment supplier can protect its profit margins from recoupment by establishing a compliance culture that collects adequate documentation and submits proper billing claims, but it is equally important for a supplier's bottom line to defend and appeal erroneous Medicare recoupments. Below are a few tips for defending claims from start to finish.Help Your AttorneyInvolving an attorney at the ADR letter stage is not always necessary, but a response that does not provide adequate...

ALJ appeals, Polsinelli, Ross Burris


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