HME News

MAR 2018

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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Smart Talk hme news / march 2018 / 11 e ngaged Te C hnology l egal d on't violate your payer contracts By t o DD Moo D y Q. I am not in network with a certain third-party payer. Can I enter into a subcontract agreement with another d M e supplier that is in network with that payer? a . This is probably not a good idea. First, it is important to note that the other supplier's payer contract likely has provisions related to subcontracting that either prohibit the supplier from subcontracting functions under the contract or requiring the supplier to get permission from the payer before subcon- tracting. So the arrangement could violate the terms of the payer contract. Second, even if the payer contract is silent about sub- contracting, if the arrangement consists of the non-contracted supplier doing all of the work with the contracted supplier merely submitting claims as a representation that the con- tracted supplier furnished the items or services, it is possible the arrangement could amount to insurance fraud under state law. And third, the arrangement could violate both federal and state anti-kickback statutes, which generally prohibit a per- son from soliciting, receiving, offering, or paying anything of value in return for, or to induce referrals or the arrangement of referrals of certain individuals. T h e i n s u r e r o r a n o t h e r enforcement authority could argue that the contracted sup- plier is arranging for the non- contracted supplier to receive referrals or patronage, or vice versa, in exchange for a portion of the collections resulting from the referrals or patronage. hme Todd Moody is a healthcare attorney with Brown & Fortunato. Reach him at medtrade booth 825 Focus your strategy By Val o rnoy Q. h ow can m h ealth technology engage patients? a . With one-fifth of the U.S. popu- lation trending to be 65 or older by the year 2030, mobile health (mHealth) will continue to drive innovation, automation and great- er integration for HME provid- ers. As you consider strategies to address the large-scale economic and health needs of this grow- ing population you will need to include the "Silver Tsunami's" mobile aspects in your plans. In particular, determine how the increasing adoption of mHealth technology by older adults will increasingly foster coordinated and connected care. Mobile-centric connectivity across all care providers, home health agencies, family, senior liv- ing, and community support orga- nizations can deliver greater peace of mind not only to the patient but their entire caregiving communi- ty. The comfort that everyone in their care journey is always on the same page, communicating transparently, and accessing the data they need in a timely man- ner enables the ability to provide the best and earliest care possible. Thus, mHealth technology strate- gies should focus on: 4 Information that can be eas- ily and securely shared from any device and any location 4 Participant interdependence and engagement 4 Technologies' ease of use, adoptability and integration 4 Results for greater caregiver efficiencies Leveraging mobile technology to connect elder patients to their ever-changing caregivers, and to one another, allows the care eco- system to flex, adapt, and move with them from a hospital visit, to rehab scenarios, back to home. Additionally, the data, people and devices related to care activities can be synchronized to stay cur- rent and always relevant. hme Val Ornoy is CEO of LifeAssist Technologies. Reach him at val@lat. care.

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