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Brown & Fortunato

In brief: Noridian named new SMRC contractor, Bachenheimer opens DC office for Brown & Fortunato

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03/23/2018

FARGO, N.D. – Noridian Healthcare Solutions has been awarded a $227 million Supplemental Medical Review Contractor (SMRC) contract by CMS. The primary role of the SMRC is to conduct nationwide medical review of Part A, Part B and DME providers as directed by CMS.

Bachenheimer opens DC office for Brown & Fortunato

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03/23/2018

WASHINGTON – Cara Bachenheimer, a long-time advocate of the HME and complex rehab industries, is opening up a Washington, D.C., office for Amarillo, Texas-based Brown & Fortunato.

Legal: Don’t violate payer contracts

Q. I am not in network with a certain third-party payer. Can I enter into a subcontract agreement with another DME supplier that is in network with that payer?
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02/27/2018

A.  This is probably not a good idea.

Legal: Mind the threshold

Q. Can I pay a lead generation company for leads?
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01/25/2018

A.  Yes, but the appropriate payment terms will depend on the nature of the leads.

Single-source contract ‘promotes favoritism’

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08/28/2017

AMARILLO, Texas – HME providers in Texas have solid ground to stand on when it comes to their criticism of a new Medicaid contract that makes Medline a single-source provider of 244 DME supplies, says an industry attorney.

Overpayments: Create culture of compliance

Q. What is the best remedy for overpayment problems?
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08/22/2016

A. In previous columns, I discussed how the 60-day overpayment rule presents a myriad of problems and questions that are sometimes difficult for an HME supplier to identify and address.

Overpayments: Follow protocol

Q. How do I return an overpayment to the government?
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07/25/2016

A. Typically, suppliers report and return overpayments to the DME MAC of jurisdiction. Each DME MAC has a standard overpayment refund form. The supplier simply provides information and submits a refund check.

Overpayments: Extrapolate overpayments

Q. How deeply do I need to investigate potential problems?
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06/21/2016

A. My last column explained CMS’s final rule clarifying the 60-day rule, which allows a supplier up to six months to quantify an overpayment once it’s identified.

Overpayments: Exercise reasonable diligence

Q. What do I need to know about the 60-day rule?
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05/23/2016

A. The Affordable Care Act requires a person who has received an overpayment to report and return the overpayment to the government.  

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