A call for all hands on deck to secure a better 2025 for the HME industry
TRICARE
The fraudulent telemarketing scheme harmed Medicare & TRICARE patients in eastern Washington
WASHINGTON—Thomas Andrew Webster, M.D., age 51, of Sylvania, Ohio, pleaded guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing and medical supply scheme throughout Washington and in other states, announced Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington. United States District Judge Mary K.
Thomas Andrew Webster pled guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing & medical supply scheme
SPOKANE, Washington—Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington, announced that Thomas Andrew Webster, M.D., age 51, of Sylvania, Ohio, pled guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing and medical supply scheme throughout Washington and in other states. District Judge Mary K. Dimke accepted Webster’s guilty plea and set sentencing for June 26 in Spokane, Washington.
A fraudulent medical supply scheme targeted elderly Medicare and TRICARE beneficiaries
SPOKANE, Washington—Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington, announced that Thomas Andrew Webster, M.D., age 50, of Sylvania, Ohio, has been charged by Filing of Information on one count of Conspiracy to Violate the Anti-Kickback Statue in connection with a fraudulent medical supply scheme that targeted elderly Medicare and TRICARE beneficiaries throughout Washington and in other states.
WASHINGTON, D.C. (June 26, 2020)—The American Association for Homecare (AAHomecare) recently met with TRICARE East contractor Humana Military on a range of issues, including implementation of new reimbursement rates authorized by COVID-19 relief legislation, the CARES Act.
WASHINGTON, D.C. (July 16, 2019)—Changes to the TRICARE regions to consolidate to two plans from the previous three plans have been fraught with provider network and claims processing issues. While AAHomecare has been contacted regarding these issues with both regions, the bulk of the issues have been with the TRICARE East contractor, Humana Military.
Concerns over cuts and bid limits exist for rural providers.
Via AAHomecare, WASHINGTON, D.C. (February 14, 2018)—The recently released FY 2019 budget proposal from the White House includes several items related to DME. AAHomecare has especially strong concerns about the first item noted below and plans to talk to the Administration for clarification.
Provisions found in the budget proposal and an HHS summary document include:
Rates apply for July 1 through December 31, 2016
WASHINGTON, D.C. (July 7, 2017)—TRICARE is issuing its first official acknowledgements that they will reprocess claims from July 1 through December 31, 2016 to reflect adjustments to the fee schedule mandated by last December’s CURES bill.
A letter from AAHomecare defines expectations.
—Via AAHomecare, WASHINGTON, D.C. (June 7, 2017)—With the publishing of the fee schedule by CMS, the HME industry is still awaiting the Department of Defense Health plans and timeline for implementing the Cures Act.
There is no word from the Defense Health Agency on whether claims will be reprocessed.
WASHINGTON, D.C. (February 22, 2017)—AAHomecare recently evaluated the language of the CURES Bill and how it pertains to the TRICARE network. As previously reported, AAHomecare received an attorney opinion that the language inside of the CURES Bill should relate to the TRICARE network as well.
WASHINGTON, D.C. (January 30, 2017)—The American Association for Homecare (AAHomecare) is calling on the contractors administering TRICARE military health plans nationwide to reprocess claims for home medical equipment for the last six months of 2016 on account of provisions in recent health care legislation affecting Medicare reimbursement rates.
WASHINGTON, D.C (August 26, 2016)—Home medical equipment providers who serve our nation’s military personnel are being hit with shocking new Medicare reimbursement cuts thanks to the Centers for Medicare and Medicaid Services’ (CMS) decision to widely apply rates from its competitive bidding program outside its original footprint in metro areas to now encompass the entire country.
WASHINGTON (Aug. 18, 2014) — The Partnership for Quality Home Healthcare – a leading coalition of home health providers dedicated to improving the integrity, quality, and efficiency of home healthcare for our nation's seniors – today commended House Ways and Means Subcommittee on Health Chairman Kevin Brady (TX- 8) for drafting legislation to support greater fraud prevention programs within the Medicare program.
Understand the ins and outs of providing gifts to physicians
Adjust your aim in the HME market
Jeffrey S. Baird is chairman of the Health Care Group of Brown & Fortunato, a law firm based in Amarillo, Texas. He represents HME providers, pharmacies and other health care providers throughout the U.S. The following Q&A is about the importance of setting policies that cover an HME marketing expense budget and gifts.