Medicare Fight: The Time Is Now!

For those who are truly serious about holding CMS and specifically Region C accountable for their actions and inactions, now is the time! We have located an attorney who specializes in healthcare law. He is currently researching the feasibility of filing a class action suit against the Centers for Medicare & Medicaid Services (CMS) Region C (Palmetto) Durable Medical Equipment Regional Carrier (DMERC). In order to determine whether a class action suit can be certified and initiated, we need all individuals who desire involvement and have credible evidence of wrongdoing to come forward ASAP! If you as a practitioner and/or your practice has suffered delayed payments, repeated denials, or any other type of tangible fiscal damage in the pursuit of providing care for Medicare recipients, we would like to hear from you. These accusations must be accompanied by properly submitted, legitimate, correctly filed documentation (please do not send any claims or patient documents). However, if you believe your claims have been delayed, denied, or rejected due to constant vacillation of CMS policy and procedures, and you can demonstrate a pattern of such, this too may be a cause of action. We are in need of as many complainants as possible who have tangible, factual proof of CMS Region C's violations. We need specific examples of inappropriate behaviors, types of claims, L-Codes delayed and/or rejected, numbers of claims filed with a particular code or claim rejected and/or delayed, percentages of problem claims and/codes, numbers of denials and/ or delays, quantified over specific segments of time (within the past six months, 12 months, etc.). Feel free to submit any further problematic areas regarding consistent problems in Medicare reimbursement you or your practice has suffered. Please remember HIPAA regulations and do not submit any personal information. Problems, time frames, number, dollar amounts lost in denials and/ or appeals and percentages of problematic (denied, rejected, delayed past 90 days, etc.) claims will suffice at this point. Once our evidence is collected and presented to the firm, it will determine if we can and should proceed with a class action, an individually filed suit, or if the firm will decline representation. Obviously a law firm will not accept a case on contingency unless it sees a substantial chance to win and/or publicity likely to produce revenue. If we offer a retainer, then collective damages can be a smaller sum, and the firm will accept the case. From what we have experienced and from speaking with a number of our colleagues, I see no reason why we cannot all join together, provide indisputable evidence of egregious acts numbering at least in the hundreds of thousands of dollars, and together hold CMS and specifically Region C responsible for what they have done! We certainly are very aware that seeing actual monies is a distant reality, if one at all. But we must try; we must be heard! If the final outcome produces changes that benefit recipients as well as providers, then it will be worthwhile. I firmly believe that there is a real civil case here and that initiating it may bring about investigations showing breach of federal law. With or without my colleagues, my resolve shall remain intact. However, there is strength in numbers, and every provider that has been damaged should be fairly compensated, and justice should be done for all of us! In order to be involved in this action, we must be notified, and information must be forwarded to me by September 30. Please e-mail: OkLpo1@aol.com ; fax: 405.621.9986, or send to: Advanced Orthotic Prosthetic Technologies, 5601 NW 72nd #308, Oklahoma City, OK 73132 all the above outlined factual evidence. Keith Crownover, BS, CPO, BOCPO, LPO, is co-owner and clinical director of Advanced Orthotic Prosthetic Technologies LLC, Oklahoma City, Oklahoma. He is a member of the Board of Directors of the Board for Orthotist/Prosthetist Certifi cation (BOC), a past chair of Oklahomas Prosthetist and Orthotist State Licensing Advisory Committee and past executive treasurer, International Association of Orthotics and Prosthetics (IAOP).

Medicare Fight: The Time Is Now!

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Medicare Fight: The Time Is Now!

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Ottobock Patient Care is growing!

🚨 Hanger Clinic is Hiring a Certified Prosthetist Orthotist in Philadelphia, PA!

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