Medicare Advantage Plans: Government Oversight and Industry Advocacy
Presented by Jeff Baird, Esq. of Brown and Fortunato, Co-Presenter Laura Williard, AAHomecare
Medicare Advantage Plans (“MAPs”) have had tremendous growth in enrollment in recent years. DME suppliers quite naturally ask what the federal laws are that govern MAPs. This program discusses: the current MAP environment and the federal laws that govern them, how these laws affect DME suppliers as they provide services to patients covered by MAPs, the most important issues DME suppliers must face as they work with MAPs, and the work being done to educate Congress, CMS, and the industry and the resources available to help DME suppliers navigate these plans. Members Benefit| Nonmembers $129
Copayment Collection and Patient Assistance Programs
Presented by Jeff S. Baird, Esq. and Matthew D. Earl, Esq. of Brown & Fortunato
This program discusses (i) what it means to “make a reasonable effort” to collect copayments; (ii) how a supplier can implement a financial hardship policy that allows the supplier to waive/reduce a copayment on a patient-by-patient basis; (iii) point out that the existence of such a financial hardship policy cannot be advertised; (iv) how a DME supplier can implement a patient assistance program; and (v) how a supplier can access charities that may be in the position to assist patients in paying their copayments. Members Benefit | Nonmembers $129
Proven Audit & Appeals Strategies
Presented by Noel Neil of ACU-Serve
With the public health emergency clearly in our rearview mirror, recent revisions to the oxygen and continuous glucose monitors policies, high CERT error rate for DMEPOS and ongoing OIG alerts on fraud, waste, and abuse in the DMEPOS space, I believe we are in for another eventful year for audits. For most suppliers it is not a matter of if but when their first audit will arrive. The best audit defense is good offensive plan. Being proactive and not reactive. Whether you are already inundated with Medicare audits, or you have not yet received your first one, this presentation has some helpful information for you.
The presentation will cover the following:
- The different auditing contractors and the unique role they play. For example, RAC, CERT, UPIC, SMRC etc.
- The different level of appeals, how to file those appeals.
- Proven and successful audit strategies.
- Proven and successful appeal strategies.
- Trends and tips for the current audits and appeal, and much more.
Members Benefit | Nonmembers $129
Cash-Only Retail: How to Succeed
Presented by Jeff Baird, Esq. of Brown & Fortunato
Seniors account for a large share of patients served by the DME sector. This means that many DME suppliers are dependent on traditional Medicare and Medicare Advantage for a major part of their revenue. But as DME suppliers know from experience, it can be challenging to be so tied to Medicare. This is where retail comes in. There are 78 million Baby Boomers who are retiring at the rate of 10,000 per day. Many Boomers are willing to pay cash for “Cadillac” items rather than being limited to the “Cavalier” items paid for by Medicare. This program will present the legal parameters within which DME suppliers can move into the retail space. The issues to be presented will include the following:
- Whether the retail business should be (i) under the supplier’s existing Tax ID # or (ii) operated by a separate legal entity.
- State DME licensure.
- Selling Medicare-covered items at a discount off the Medicare allowable.
- Obtaining physician prescriptions.
- Collection and payment of sales tax.
- Qualification as a “foreign” corporation.
- Required notification to a Medicare beneficiary even though the supplier does not have a PTAN.
Member Benefit | Nonmembers $129
Payer Negotiations: Know Your Plan
Presented by David Chandler, AAHomecare and Amanda Yavorsky of McKesson
Are you preparing to negotiate with a payer? Do you know which resources and data will help you make the best argument?
Join this webinar to prepare and make a plan for your company to make the most of your payer negotiation meetings. David Chandler and Amanda Yavorsky will help enable suppliers to build their own story and leverage it for upcoming negotiations by focusing on the process of preparing for a payer negotiation meeting. The presentation will break down 4 key areas: 1. Pre-negotiation homework. 2. Preparing the presentation. 3. Negotiation tips. 4. Resources to facilitate the process.
Member Benefit| Nonmembers $129
Safeguarding Access to Enteral Nutrition
Presented by: Pam Pacht, Nestle Health Science, Cameo Zehnder, Pediatric Home Service, Kristina McIntosh, Schraders' Medical Supply, Vicki Emch, Aveanna Healthcare
Enteral Nutrition has an integral role in HME. More than 400,000 people use feeding tubes in the U.S. each year, including infants, children and adults. Proper EN management by knowledgeable HME providers is critical to prevent malnourishment and negative health outcomes. Yet current market conditions create significant challenges to ensuring access.
This webinar will reference the white paper developed by EN stakeholders “Challenges in Enteral Nutrition Access & Management: Safeguarding Life-Sustaining Enteral Nutrition”, while walking through critical steps to help providers:
- Ensure access for our most vulnerable patients
- Advocate for the benefit
- Identify ongoing support and expertise
- Articulate to payers and legislators the value of services provided
Member Benefit | Nonmembers $129
Employee Retention Tax Credit
Presented byJeffrey Baird, Esq. of Brown & Fortunato & Kianna L. Sitarski, Esq. of Brown & Fortunato
The COVID pandemic was unprecedented … and traumatic … for all of us. In response, the federal government passed laws – and issued regulations – designed to (i) provide “safety nets” to businesses, (ii) expand the provision of health care in the home, and (iii) assist families financially. A key provision is the Employee Retention Tax Credit that is designed to encourage employers, that are adversely affected by the pandemic, to keep employees on their payroll. Since its inception in 2020, the Employee Retention Credit has been modified by federal statute and IRS regulations to relieve financial struggles faced by employers.
This webinar will discuss the history of the Employee Retention Credit, including eligibility and value of tax credits available for wages paid between March 2020 and December 31, 2021. The webinar will also discuss how to retroactively claim the Employee Retention credits and common pitfalls to avoid when the DME supplier is amending its tax filing. Lastly, the webinar will discuss how the DME supplier can avoid the scams that have arisen in conjunction with the Employee Retention Tax Credit.
Member Benefit| Nonmembers $129
