Re: stock and bill in MD offices
Description
Collection
Title:
Re: stock and bill in MD offices
Text:
In the past six months we have experienced an explosion of stock and bill
arrangements with MD's( mainly orthopedists) by sales reps for leading knee
brace and soft goods manufacturers. These are the same sales reps that visit
our office trying to drum up sales.
It is my understanding that:
The sales rep inventories a comprehensive supply of soft goods in the
orthopedists office. MD office staff fits and supplies. The sales rep pays
rent to the MD. The sales rep re-supplies inventory weekly or more frequently
as needed. The mechanics of billing the patient are handled by the sales
rep's corporate office.
This arrangement benefits MD by: No out of pocket expense for inventory.
Retain control of patient referal pattern. Money in their pocket (kickback
disguised as rent)
Patient might get saved a trip to their local orthotist (if it was done right
the first time).
To the outsider it seems to be a pretty good arrangement for MD, sales rep
and lucky patient.
My questions are:
Who is actually the provider of record for this devcie? Who is laible in the
event of a product failure?
MD because his staff fitted it? Sales rep because they billed for it?
In the event of a Medicare beneficiary obatining such a service/device is
the MD double dipping or unbundling when he/she bills an office visit fee
while the sales rep bills the device fee? Is it considered fraud when the
sales rep bills for the device but does not provide the servcie? (Lcode
allowables already include a servcie component for fitting, training and
follow-up adjustment)
What can/should be done? By whom? To whom?
Where should the efforts to combat this be focused?
Is it considered collusion if we avoid purchasing from entities that support
and actively promote stock and bill practices? THEY earn a commission from
every brace YOU sell because they are also YOUR sales rep and your
compettiton.
Keep in mind the MD has a financial stake and will likely NOT give it up
easily.
Please reply to list. This topic will impact every orthotist in the very near
term.
Replies should be interesting.
Ralph W. Nobbe, CPO
arrangements with MD's( mainly orthopedists) by sales reps for leading knee
brace and soft goods manufacturers. These are the same sales reps that visit
our office trying to drum up sales.
It is my understanding that:
The sales rep inventories a comprehensive supply of soft goods in the
orthopedists office. MD office staff fits and supplies. The sales rep pays
rent to the MD. The sales rep re-supplies inventory weekly or more frequently
as needed. The mechanics of billing the patient are handled by the sales
rep's corporate office.
This arrangement benefits MD by: No out of pocket expense for inventory.
Retain control of patient referal pattern. Money in their pocket (kickback
disguised as rent)
Patient might get saved a trip to their local orthotist (if it was done right
the first time).
To the outsider it seems to be a pretty good arrangement for MD, sales rep
and lucky patient.
My questions are:
Who is actually the provider of record for this devcie? Who is laible in the
event of a product failure?
MD because his staff fitted it? Sales rep because they billed for it?
In the event of a Medicare beneficiary obatining such a service/device is
the MD double dipping or unbundling when he/she bills an office visit fee
while the sales rep bills the device fee? Is it considered fraud when the
sales rep bills for the device but does not provide the servcie? (Lcode
allowables already include a servcie component for fitting, training and
follow-up adjustment)
What can/should be done? By whom? To whom?
Where should the efforts to combat this be focused?
Is it considered collusion if we avoid purchasing from entities that support
and actively promote stock and bill practices? THEY earn a commission from
every brace YOU sell because they are also YOUR sales rep and your
compettiton.
Keep in mind the MD has a financial stake and will likely NOT give it up
easily.
Please reply to list. This topic will impact every orthotist in the very near
term.
Replies should be interesting.
Ralph W. Nobbe, CPO
Citation
“Re: stock and bill in MD offices,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 8, 2024, https://library.drfop.org/items/show/217005.
