Free legal advice Friday

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09/22/2017

When you speak to industry attorneys, you get a wealth of information, more than can fit into a 400-word story for the November issue. So here are some outtakes from my recent conversations with Jeff Baird:

Same or separate

If an HME company wants to explore retail, it has two options, Baird says: They can do it under their existing company, ABC Medical, which has a PTAN; or a separate company, ABC Retail, which has no PTAN.

Baird says he prefers the latter option, because it eliminates a number of potential problems.

“For example, if you’re selling stuff for cash under one entity with one tax ID, you have to deal with anti-discrimination concerns between your Medicare and cash customers,” he said. “If you have a separate entity, those concerns go away.”

Additionally, if ABC Medical for one reason or another goes down in flames, ABC Retail still stands, Baird says.

“I think it scares people to set up a separate entity, but it shouldn’t,” he said.

The party’s over

Baird has long warned of “the big party going on with folks selling braces and sham telehealth arrangements.” Well, the party has come to an end, he says.

“We have now seen a number of letters, not from the NSC, but from CMS to mail-order orthotics providers saying, you know you’re selling in 30 states and in three of those states you don’t have the right licensure, so we’re going to revoke your PTAN,” he said.

Baird calls the move “pretty wicked.” In the past, a provider would get a letter from the NSC asking for a corrective action plan on how they plan to address the issue.