Q&A: Know thy subcontractor

ATLANTA - If you're an HME provider looking into outside marketing agencies, do your homework first, says Michael Silverman, an attorney with Florida Healthcare Law Firm. HME News spoke to Silverman, a panelist on the “Compliantly Making Money and Best Practices to Keep It” session at Medtrade, about how to choose a subcontractor and red flags to avoid.

HME News:  Is there a best practice providers should prioritize?

Michael Silverman:  In this industry, in this day and age, it's extreme vetting and due diligence. If you dare to subcontract, it's really important to know thy subcontractor, because you're going to be held accountable, ultimately, as the provider. So for folks working with any outside marketers, first and foremost, it's education, education and education. Falling short of that sets people up for failure.

HME: Any red flags providers should be on the lookout for when considering a subcontractor?

Silverman: Any type of marketing offering on a per-lead, per-referral basis is a red flag from a regulatory anti-kickback perspective. And of course, any type of fee-splitting of revenue that's realized by the supplier by virtue of those marketing activities—certainly steer clear of those models and run the other way. It really boils down to: If it looks too good to be true, it probably is.

HME: This may sound naïve, but are there companies out there, knowingly or unknowingly, running those fee-splitting business models?

Silverman: Yes, yes, yes, yes and yes. And that's the reason I do these educational events, because who wouldn't be attracted to somebody offering to help expand and grow your business overnight? A lot of these marketers aren't aware of the rules or laws or the regulations, or they are aware and they just don't care because at the end of the day, they're not on the front lines billing Medicare. Also, many of these marketers are used to selling direct-from-TV advertisements, and they think they can treat HME just like another line of business, but that's not the case. They have to realize they're not selling widgets; they're dealing with patients' lives and the federal healthcare system, and it has to be treated appropriately.