Durable Medical Equipment and Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers

Overview
DMEPOS Legal Experience
DME Recent Focus Areas
POS Recent Focus Areas
Outside Resources
Articles
Speeches
Contact Us

Overview

The attorneys of Wachler & Associates understand the legal and regulatory areas impacting Durable Medical Equipment and Prosthetics/Orthotics suppliers and represent both supplier types in all aspects of their legal needs. Wachler & Associates regularly counsel DMEPOS clients on matters including:

• Fraud and Abuse counseling including relationships with doctors to increase compliance with the Stark law and Anti-Kickback Statute
• RAC, ZPIC, MAC, Medicaid, or private pay audits and appeals
• Competitive bidding issues
• Counseling for DME relationships with sleep labs
• Operations, corporate governance, structural issues, and compliance policies
• Contractual and transactional arrangements
• HIPAA compliance
• Medicare enrollment and compliance
• Compliance with Medicare and Medicaid coding and payment regulations
• Managed care contracting
• Purchase and sale of DME companies
• Consignment issues and physical location requirements
• State registration and licensure
• FDA compliance
• Other regulatory and health care law matters

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DMEPOS Legal Experience

• Compliance Plans — Wachler & Associates has provided high quality compliance plans to providers and suppliers for over 35 years. We have developed and implemented comprehensive compliance programs, including compliance training and assistance with self-auditing. For example, we have counseled DMEPOS suppliers regarding their relationships with physicians and sleep labs to ensure compliance with the Stark law and the federal Anti-Kickback Statute. Over the years, we have drafted workbooks on both HIPAA Privacy and Security and presented at seminars educating provider organizations across the country, including the American Orthotics and Prosthetics Association and the Michigan Orthotics and Prosthetics Association. We also specialize in counseling clients on compliance with Fraud and Abuse laws, Medicare and Medicaid regulations, and HIPAA.
• Purchase and Sale of DMEPOS Companies – Healthcare can be a precarious business in terms of audit and regulatory liability. As a result, purchasing a DMEPOS company requires thorough due diligence regarding the compliance of the existing entity with regulatory requirements and Medicare claims submission requirements. It is also important for purchasers to understand what steps must be taken in order to transfer Medicare billing privileges. In addition, there are warranty and indemnification provisions that purchasers can use to provide greater protection. In many cases, Stark and other Fraud and Abuse laws may be applicable. The attorneys of Wachler & Associates have expertise in advising clients on purchasing and selling healthcare businesses including DMEPOS companies.
• Audits – Medicare and third party payors often target DMEs in audits covering a range of risk areas. In 2008, one in every four DME suppliers was penalized by Medicare. Our firm is a nationwide leader in RAC, ZPIC, Medicare, Medicaid, and third party payor defense. Please see our healthcare audit defense website for more information on how we can help you present the best defense possible.
• Purchasing and Supply Chain Agreements – The purchase and sale of medical equipment, products, and devices have several healthcare legal implications, such as fraud and abuse, HIPAA, FDA, and industry guidance. Our attorneys have significant experience in representing healthcare providers, suppliers and entities with regulatory compliance, acquisitions, and supply chain operations. Our firm also has experience advising vendors, manufacturers, and distributors regarding sales and regulatory compliance. Our attorneys specialize in drafting, reviewing and negotiating contracts. Finally, we have extensive experience advising clients on regulatory issues concerning group purchasing organizations and physician-owned distributorships.

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DME Recent Focus Areas

• Financial relationships with physicians
• Medical director agreements
• Billing requirements
• Motorized wheelchair challenges

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Prosthetics/Orthotics Recent Focus Areas

• HIPAA compliance
• Prefabricated or custom items
• Qui tam (Whistleblower) Cases
• Financial relationships with physicians
• Fee Schedule

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Outside Resources

For the Center for Medicare and Medicaid Services’ Durable Medical Equipment page, please click here.

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Articles

Our attorneys have written many articles on issues relevant to DMEPOS suppliers. For a list of Wachler & Associates articles, please click here.

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Speeches

The attorneys of Wachler & Associates often speak on issues relevant to DMEPOS suppliers. For a list of Wachler & Associates speaking engagements, please click here.

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Contact Us

Call us at (248) 544-0888 or send us an e-mail to schedule a meeting to discuss your DMEPOS-related concerns or to address your other healthcare law-related needs.

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