Canton Foot & Ankle Specialists PC, DAB CR6753 (2025)

DECISION

Petitioner, Canton Foot & Ankle Specialists PC, is a supplier of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), located in Canton, Michigan.  Petitioner participated in the Medicare program as a supplier of services.  The Centers for Medicare & Medicaid Services (CMS) has revoked its Medicare supplier number, and Petitioner appeals. 

I find that CMS properly revoked Petitioner’s supplier number. 

Background

Until its Medicare supplier number was revoked, Petitioner participated in the Medicare program as a DMEPOS supplier.  See 42 C.F.R. § 424.57.  In a letter dated August 20, 2024, the Medicare contractor, Novitas Solutions, notified Petitioner that its Medicare supplier number was revoked, pursuant to 42 C.F.R. §§ 424.57(c)(7)(i)(D), 424.535(a)(1), 405.800; 424.57(e), and 424.535(g).  The letter noted that the contractor conducted an unannounced site visit on November 7, 2023.  And, that at the time of the visit, there was no permanent visible signage with the Petitioner’s name and no hours 

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posted.  CMS Ex. 5 at 1-2.  The letter also informed Petitioner that CMS was imposing a one-year re-enrollment bar.  Id. at 3.  

Petitioner filed a corrective action plan (CAP).  CMS Ex. 7 at 3.  The CAP showed that Petitioner had corrected the name on its visible signage but did not post their hours as required by 42 C.F.R. § 424.57(c)(7)(i)(D).  Id.  As a result, the contractor found that the CAP failed to correct the deficiencies which led to the revocation.  Id.  

Petitioner also sought reconsideration on October 18, 2024.  CMS Exs. 6, 7.  In a reconsidered determination, dated March 27, 2025, Medicare contractor Chags Health Information Technology affirmed the revocation of Petitioner’s supplier number.  CMS Ex. 7.  Petitioner now appeals that determination pursuant to 42 C.F.R. § 424.545, and CMS moves for summary judgment.  With its request for hearing, Petitioner included photos dated more than 5 months after the date of the reconsideration request and the CAP.  

Although CMS has moved for summary judgment, I find that this matter may be decided on the written record, without considering whether the standards for summary judgment are satisfied.  In the initial order issued1 on May 6, 2025, the administrative law judge instructed the parties to list all proposed witnesses and to submit their written direct testimony.  Standing Order at 5-6 (January 27, 2025).  The Standing Order notes that each party has the right to cross-examine any witness for whom the opposing party offers written direct testimony; however, the party must affirmatively indicate that it wishes to do so.  Standing Order at 9 (¶ 12).  A hearing would be necessary only if a party files admissible, written direct testimony, and, in compliance with the order, the opposing party asks to cross-examine.  Standing Order at 9 (¶ 13). 

Neither party lists any witnesses.  Because there are no witnesses to be examined or cross-examined, an in-person hearing would serve no purpose.  This matter may therefore be decided based on the written record. 

With its motion and brief (CMS Br.), CMS has submitted seven exhibits (CMS Exs. 1-7).  Petitioner submitted a short response with no exhibits (P. Br.).  

In the absence of any objections, I admit into evidence CMS Exs. 1-7. 

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Discussion

1. 1. CMS properly revoked the supplier’s billing privileges, because the facility failed to have permanent visible signage with Petitioner’s name and hours posted .2

Requirements for a DMEPOS supplier’s Medicare participation.  To receive Medicare payments for items furnished to a Medicare-eligible beneficiary, a supplier of medical equipment and supplies must be enrolled in the Medicare program and must have a supplier number issued by the Secretary of Health and Human Services.  Social Security Act § 1834(j)(1)(A); 42 C.F.R. § 424.505.  To keep that number, the supplier must be operational and must meet the standards set forth in 42 C.F.R. § 424.57(c).  CMS may revoke its billing privileges if it fails to do so.  42 C.F.R. § 424.57(c)(1), (d); 42 C.F.R. § 424.535(a)(1), (5). 

To be operational, the supplier must, among other requirements, have a qualified physical practice location, be open to the public, and be properly staffed, equipped, and stocked to furnish items and services.  42 C.F.R. § 424.502.  A DMEPOS supplier must also have permanent visible signage with posted hours of operation.  42 C.F.R. § 424.57(c)(7)(i)(D).  The supplier’s location must be accessible during reasonable business hours.  The supplier must permit CMS or its agents to conduct on-site inspections to ascertain its compliance with governing regulations.  42 C.F.R. § 424.57(c)(7), (8). 

Where, as here, a contractor’s representative finds the facility does not have permanent visible signage with posted hours of operation, the supplier does not meet the requirements of section 424.57(c), and CMS may appropriately revoke its billing privileges. 

The parties do not dispute the basic facts of this case. 

When the contractor conducted its unannounced onsite visit on November 7, 2023, the site was open and operational, but there was no visible signage with Petitioner’s name and no posted hours.  CMS Ex. 7 at 2-4; P. Br. at 1.  As a result, a revocation notice was issued on August 20, 2024 revoking Petitioner’s billing privileges for failure to have visible signage and posted hours of operation.  CMS Ex. 5.  Petitioner filed a CAP on October 18, 2024.  P. Br. at 1.  The CAP corrected the visible signage requirement but failed to address the hours of operation.  CMS Ex. 7 at 3.  Petitioner also filed a request for reconsideration on October 18, 2024.  CMS Ex. 6.  The March 27, 2025, reconsidered determination affirmed the revocation.  CMS Ex. 7 at 4. 

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Petitioner admits in its brief that the hours of operation were still not posted at the time the CAP was submitted.  P. Br. at 1.  Petitioner argues that it “inadvertently overlooked” the posted hours of operation requirement when it filed the CAP.  P. Br. at 1.  Petitioner included photos dated April 28, 2025, with its hearing request to show that hours of operation have now been posted.  Request for Hearing at 5-6.  There is no claim made that the hours of operation were properly posted at the time of the unannounced site visit or when the CAP was submitted. 

Petitioner was required to have permanent visible signage and posted hours of operation.  By its own admission, these were not present at the unannounced inspection on November 7, 2023 and the hours remained unposted at the time of the CAP.  Petitioner was therefore not in compliance with section 424.57(c)(7)(i)(D), and CMS justifiably revoked its billing privileges under section 424.57(e). 

2. 2. I have no authority to review CMS’s determination to impose one-year reenrollment bar. 

When a supplier’s billing privileges are revoked, it may not participate in the Medicare program until the end of its reenrollment bar, which must be for a minimum of one year but no more than ten years (except under circumstance that don’t apply here), depending on the severity of the underlying offense.  42 C.F.R. § 424.535(c)(1).  Here, CMS imposed a one-year reenrollment bar. 

I have no authority to review the length of a reenrollment bar.  See 42 C.F.R. § 498.3(b); Linda Silva, P.A., DAB No. 2966 at 11 (2019); Vijendra Dave, M.D., DAB No. 2672 at 9-12 (2016); accord, William Garner, MD, DAB No. 3026 at 16 (2020), Lilia Gorovits, MD, DAB No. 2985 at 15-16 (2020).  I am authorized to review initial determinations “to deny or revoke a provider or supplier’s Medicare enrollment in accordance with . . . [section] 424.535.”  42 C.F.R. § 498.3(b)(17).  As the Board observed in Vijendra Dave, the regulations confer no such right to appeal CMS’s determination concerning the duration of a post-revocation reenrollment bar.  DAB No. 2672 at 10. 

Conclusion

Because Petitioner failed to post visible signage with its name and hours of operation, I sustain CMS’s revocation of Petitioner’s supplier number.