Chilivis Grubman LLP
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MEDICARE’S “WITHOUT FAULT” PROVISION: A PROVIDER’S SECRET WEAPON?

Mar 24, 2025 | Administrative Law, Health Care, Medicare and Medicaid, Overpayment Appeals

Because Medicare processes over one billion fee-for-service claims annually, it is impossible for CMS and its contractors to review every claim – or even a substantial percentage of claims – on a pre-payment basis.  Accordingly, Medicare has set up various...

Opt-in DME Leads and Medicare’s Anti-Solicitation Rule

Feb 20, 2025 | DMEPOS, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid

If you are a DMEPOS supplier and are purchasing opt-in Medicare leads, you should be aware of Medicare’s prohibition against telephone solicitation of beneficiaries. In order to enroll as a Medicare DMEPOS supplier, and as a condition of payment, DMEPOS providers must...

CMS Issues Final Regulations Regarding Medicare 60-Day Rule

Nov 11, 2024 | Health Care, Medicare and Medicaid

When the Affordable Care Act was passed and signed into law by President Obama in 2010, one of its provisions required Medicare providers and suppliers to report and refund Medicare overpayments within 60 days of “identifying” such an overpayment.  Violating this...

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