MD's as DME?

[mahadev]

Can a Physician bw a DME supplier for CPAP?

[lktnky]

Sounds like a conflict of interest to me.

[mayondair]

I'd rum the other way.

[roster]

Can a Physician bw a DME supplier for CPAP?

In the U.S., it is not a problem if you come here and learn things like, "you have a legal right to your prescription and can take it and buy CPAP equipment from other suppliers."

If your physician expresses dislike for this, have all your records sent (another legal right) to a different physician who cares for the interests of his patients.

[guestagain]

UNETHICAL

[cwied]

My Optometrist's office sells glasses. I don't think the issue is black and white. The MDs probably make more money out of repeat visits than they would off the equipment.

At some level, you have to trust your doctor. If you don't, you should probably try to find a different doctor if you're able to. Also, educate yourself about your condition so you can judge whether what the doctor is telling you makes sense.

[Hose_Head]

My Optometrist's office sells glasses. I don't think the issue is black and white. The MDs probably make more money out of repeat visits than they would off the equipment.

In Ontario, Optometrists who sell glasses can only sell them at their cost, plus a small dispensing fee.

[Hose_Head]

Sounds like a conflict of interest to me.

The same would go for an MD who has a financial interest in the DME, no matter how small.

[idamtnboy]

Sounds like a conflict of interest to me.

The same would go for an MD who has a financial interest in the DME, no matter how small.

Maybe not always. In my case the Dr works for, or maybe is part owner, of the sleep center where I went. He is one of two doctors in the sleep center. The center is a part of, but not totally owned by, a large local medical group. At least that's my understanding. The doctors in this medical group, I believe, are all salaried. When I was told that I need to get a CPAP the center gave me a questionnaire that listed about twenty local area DMEs. The sleep center was on the list. I was asked to check off one or more DMEs who I would prefer to have provide the CPAP. I checked off three I think. They sent the script to a DME I did not check off, but who regularly services the outlying town I live in. This same large medical group has a pharmacy and optical shop in their office building. I have never seen any push whatever by the doctors, or their staffs, to use the in house providers. Conflict of interest? In theory, maybe; in practice, I think not.

[GumbyCT]

I was asked to check off one or more DMEs who I would prefer to have provide the CPAP. I checked off three I think. They sent the script to a DME I did not check off, but who regularly services the outlying town I live in. This same large medical group has a pharmacy and optical shop in their office building. I have never seen any push whatever by the doctors, or their staffs, to use the in house providers. Conflict of interest? In theory, maybe; in practice, I think not.

What or how do you classify sending your medical information (prescription) to a DME you did not check off? That's not trying to push your business some where?

They all should avoid the appearance of any conflict, period.

[jnk]

"We believe that it is highly unlikely that a referring physician would meet the criteria for personally performed services when dispensing CPAP or other DME equipment. Thus, the dispensing of CPAP equipment by a physician would almost always constitute a 'referral' for purposes of the physician self-referral statute, as would the dispensing of CPAP equipment by anyone else affiliated with the referring physician, such as a nurse or physician assistant. We note that CPAP equipment is DME that does not qualify for the in-office ancillary services exception."

http://www.healthlawyers.org/Lists/Star ... rrangement

[idamtnboy]

I was asked to check off one or more DMEs who I would prefer to have provide the CPAP. I checked off three I think. They sent the script to a DME I did not check off, but who regularly services the outlying town I live in. This same large medical group has a pharmacy and optical shop in their office building. I have never seen any push whatever by the doctors, or their staffs, to use the in house providers. Conflict of interest? In theory, maybe; in practice, I think not.

What or how do you classify sending your medical information (prescription) to a DME you did not check off? That's not trying to push your business some where?
They all should avoid the appearance of any conflict, period.

I believe they sent the script to a DME who they knew had a representative who lives only a few miles from me and would deliver the machine to my home. Then again, maybe they have the most confidence in this supplier. I don't know. I didn't know anything about any of the DMEs on the list so had no reason to question who they sent it to. In fact, I think the fact they provided a list of DMEs to choose from demonstrated a desire to be open about who could provide me the unit. Friends of mine who have gone to the same clinic have been directed to other DMEs in the area, usually to one close to them. Checking off the DMEs I did was no more of an informed choice than throwing darts blindfolded. They could have had me get the equipment from them, but they didn't. I figure that counts for something.

[Slinky]

Your insurance coverage may have influenced the decision where to send your script.

Vaguely, from memory, there is a difference in the designation of sleep lab, sleep center, etc. "Full service" sleep testing facilities are allowed under certain regulations.

[msradar65]

When I had terrible time getting my sleep study approved, the sleep lab gave me a list of DME providers they generally deal with in the area. Then I went to my insurance and asked for a list of in network DME providers. I compared the two lists and started calling from there.

The sleep center also told me they have one provider that they do not refer to that frequently, but use them when the patient has usual or difficult insurance as they accept all the common insurance companies and the really odd and difficult ones as well. I was in that situation. The sleep lab did not chose one for me...but she let me know that if none on the list worked, there was one that she always referred to as last resort. Which this is the company I have gone with.

I came here to the site to learn the ropes and decide the route to take. I knew I wanted the machine with the most flexibility and one of the latest on the market. I had pretty much decided I wanted an S9 autoset.

So I started calling around from there. The DME I went with was the one that was the most friendly and open. She did not hesitate to send me a estimated sheet of the costs, their cost, what they charged to my insurance and what was my part. She explained how the whole system worked and even gave me the billing codes. She answered every question I had and was very open! I am sure she could tell I was a shrewd shopper. I went with this company and I been very pleased.

I let the sleep lab and my doctor know how well I was treated by my DME. Because as we all know word of mouth referral goes a long way. The sleep lab personnel were very glad to hear how pleased I was and they have been referring more paients to them based on my opinion and the DMEs standard choice of machine they issue...which is S9 autoset.

[idamtnboy]

Your insurance coverage may have influenced the decision where to send your script.

Vaguely, from memory, there is a difference in the designation of sleep lab, sleep center, etc. "Full service" sleep testing facilities are allowed under certain regulations.

Primary insurance is medicare. I don't think they do any steering at all. Just have to be an approved supplier.