In an attempt to further protect Medicare and its beneficiaries, the Centers for Medicare & Medicaid Services has issued a proposed rule to enhance the enrollment standards for durable medical equipment, prosthetics, orthotics and supplies for DMEPOS suppliers.
CMS has created five new standards and is strengthening seven of the 21 existing standards that suppliers must meet to ensure that they are providing quality products and services.
"In a related effort, CMS is ... launching a new DMEPOS competitive bidding program that will save money for Medicare and for beneficiaries paying a co-insurance of 20 percent of the cost of a DMEPOS item, while improving quality," said CMS Acting Administrator Kerry Weems.
As part of the new measures, suppliers in the DMEPOS competitive bidding areas would need to be accredited before winning CMS contracts. New suppliers would have to apply to the National Supplier Clearinghouse (NSC) for a supplier number before March 1 and seek accreditation by December 31 of this year.
If suppliers wait until March 1, they would have to obtain accreditation before getting a supplier number. All other suppliers must be accredited by Sept. 30, 2009.
"The proposals represent the next step in Medicare's ongoing efforts to ensure its beneficiaries continue to have access to high quality products and services at appropriate prices, while protecting them and the program from unscrupulous suppliers," said Weems. "In addition to meeting the enrollment standards, all DMEPOS suppliers are required to obtain accreditation from one of 10 accrediting organizations announced in November 2006."
The enrollment standards would affect all suppliers, not just those participating in the durable medical equipment bidding program. The standards would also apply to suppliers of all types of DMEPOS prescribed by the beneficiary's physician, from canes and walkers to power wheelchairs, oxygen supplies and equipment and hospital beds.
One of the new standards would require DMEPOS suppliers, except suppliers of prosthetics and orthotics, to be open to the public for at least 30 hours a week.
The new standards would require DMEPOS suppliers to notify the NSC of any adverse legal action, change of location or change of ownership within 30 days in order to be eligible to continue to receive Medicare payments. In addition,
suppliers would not be able to share a practice location with another Medicare supplier, and they would have to maintain ordering and referral documentation for seven years.
Finally, DMEPOS suppliers who have a federal or state tax delinquency would not be able to obtain billing privileges or retain those that they already have.
Among the current standards that would be strengthened under the CMS proposals: (bullet points)
suppliers would have to maintain a location or office where they store business records and retain documentation of orders and referrals;
the NSC must be listed as a certificate holder on the comprehensive liability insurance policy;
existing limits on when and how a supplier may contact Medicare beneficiaries would be expanded; and
the use of cell phones, beeper numbers, pagers and the exclusive use of answering machines and services as the primary phone number during posted hours of operation would be limited.
"CMS is committed to ensuring that Medicare beneficiaries are confident that the DMEPOS suppliers from whom they obtain these items are honest businesses and that they are getting quality equipment, prosthetics, orthotics and supplies at fair prices," said Weems.
Comments will be accepted until March 25, and a final rule will be published later this year.