DME Revocation

For DME suppliers, a notice from CMS can be daunting, especially when you're trying to figure out the difference between a TPE, SMRC, and UPIC. Each of these audit contractors has a different mission, scope, and level of risk for your business. Our latest blog post breaks down the "alphabet soup" of CMS audits, explaining what each entity does, what they look for, and how you should respond when they contact you. Protect your business by understanding who is on the other side of the audit.

For DME suppliers, a letter from a Unified Program Integrity Contractor (UPIC) is not a routine records request; it's a high-stakes fraud investigation that can trigger payment suspensions and threaten your company's survival. Our latest article explores the aggressive tactics of these powerful auditors, identifies the specific CMS contractors that monitor and police the industry, and details the common billing patterns that can place your business directly under their microscope. Read our guide to understand the immense financial risks of a UPIC audit and learn how to prepare for and respond to this critical business threat.

In a CMS audit, your documentation is your only defense. A missing signature or an incomplete progress note can lead to a costly overpayment demand. Is your record-keeping system truly protecting you? This article provides a blueprint for creating an audit-proof documentation system. We cover everything from intake checklists to monthly note requirements for wound care supplies, helping you ensure every claim is fully supported and ready for scrutiny.

DME suppliers can prevent unexpected and costly license revocations by strategically applying with a "By Appointment Only" designation. This article explores the common compliance trap of failing unannounced site visits due to conflicts between standard pharmacy operating hours and Medicare's "posted hours" requirement for DME suppliers. "By Appointment Only" status is a crucial safeguard, which suppliers can take to implement to protect their DME billing privileges.

If you are a Durable Medical Equipment (DME) supplier and you are fearful of being scrutinized by CMS or the National Provider Enrollment contractors for violating the onerous Medicare enrollment standards, we hope this article will help. It lays out the essential steps to maintain compliance with Medicare's enrollment requirements. We break down the complex regulations surrounding Medicare enrollment standards, covering everything from initial enrollment and accreditation to revalidation and reporting changes, and tells providers to reach out to Health Law Alliance if they are seeking advice.