From Start-Ups to Well Established Suppliers, Our Attorneys Represent DMEPOS Providers Across the Country in Compliance, Audits & Appeals, and Enforcement Matters
Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS) providers are under the regulatory microscope. Authorities, including the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services’ Office of Inspector General (HHS OIG), U.S. Department of Justice (DOJ) are paying close attention to DMEPOS providers’ marketing and billing practices, and companies targeted in audits and investigations face steep penalties and the possibility of criminal prosecution. At Silverman Bain, LLP, we help DMEPOS providers establish, maintain, and document compliance in all aspects of their operations. We also represent them in state and federal enforcement matters when necessary.
Our Services for DMEPOS Providers
Our healthcare lawyers have decades of combined experience representing DMEPOS providers at all stages of their operations and in regulatory and enforcement matters. Our services for DMEPOS providers include:
New Provider Accreditation & Medicare Enrollment
For business start-ups, between corporate documentation, state licensure, accreditation and Medicare enrollment requirements, navigating the regulatory red-tape can seem daunting. Our team is here to shine the light and assist DMEPOS providers every step of the way with obtaining accreditation and Medicare enrollment.
State Licensure Analysis
DMEPOS state licensure requirements vary by state and by product. A piece of medical equipment sold in one state may require the provider to have a license, whereas that same piece of equipment sold in another state may not. We advise DMEPOS providers on state licensure requirements applicable to their specific operations on a state-by-state and product-by-product basis.
Regulatory & Marketing Compliance
Like all entities in the healthcare sector, DMEPOS companies are subject to extensive regulatory and marketing compliance obligations; however, Medicare enrolled DMEPOS providers as subjected to a special subset of regulations, know as the DMEPOS supplier standards [insert link https://www.cms.gov/medicare/provider-enrollment-and-certification/medicareprovidersupenroll/downloads/dmepossupplierstandards.pdf]. Whether engaged in marketing to physicians or direct-to-consumer, as the consequences of non-compliance can be dire, companies must prioritize compliance both initially and on an ongoing basis. With our firm’s broad healthcare experience, we can help DMEPOS providers navigate this challenging landscape.
From billing administration and regulatory compliance to employment and cybersecurity matters, DMEPOS companies’ operations involve numerous legal issues. We help our DMEPOS clients implement policies, procedures, and other tools to manage their operational risks effectively.
Audits and Appeals
Medicare Administrative Contractors (MACs), Uniform Program Integrity Contractors (UPICs), private insurance companies, and other entities routinely audit DMEPOS providers for operational compliance. DMEPOS providers should engage legal counsel from the onset of the audit process, as mistakes can lead to unjustified recoupment demands and other unnecessary liability. Our lawyers are well-versed in all aspects of the audit and appeals process.
Fraud, Waste, and Abuse Investigations
Fraud, waste, and abuse (FWA) investigations can present substantial risks for DMEPOS providers, their officers and directors, and even their personnel. Headquartered in South Florida, our lawyers have seen it all from a healthcare fraud perspective. We represent companies and individuals in investigations involving CMS, HHS OIG,DOJ and other state and federal agencies. When facing an investigation, prompt intervention is critical,
Speak with a Lawyer about Your DMEPOS Company’s Legal Needs
If you would like to know more about our experience representing DMEPOS companies across the country, we encourage you to get in touch. Contact us to arrange a confidential consultation.