How is this legal?

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Monday, July 1, 2019

We are a small DME supplier in Santa Barbara, Ca. and are a non participating Medicare provider.

Our business is mostly home style hospital beds, ambulatory items and bathroom safety.

We have not billed Medicare in approximately 4 years, we moved to private pay, but have recently been told that we need to be completing Advanced Beneficiary Notices for all Medicare beneficiary's that choose to pay privately / out of pocket. Again we have chosen not to bill Medicare due to the low reimbursements.

We have recently tried to "opt out" of Medicare but were told that if we go this route, we can not sell to Medicare beneficiary's at all meaning that if a beneficiary comes in and wants to pay for a walker out of pocket, we have to turn down the business because they are legally entitled to use their Medicare.

We have people come into our business that have Medicare but are choosing to pay out of pocket because they don't want to have to deal with obtaining all the necessary documentation from their physician and the time it may take.

I would like to know how CVS, Walgreen's, Amazon..., both online and in store, can sell DME such as walkers, wheelchairs... with out getting an Advanced Beneficiary Notice signed or billing Medicare ?

Also how can it be legal to tell a beneficiary they have to use their Medicare when they want to or need to have their equipment today ?

Beto Antunez
Santa Barbara Healthcare