CMS Proposes to Toughen DME Supplier Standards

The Centers for Medicare & Medicaid Services (CMS) is taking comments through March 25 regarding a proposed rule to toughen DME supplier standards.

The proposed rule was published in the Federal Register on Jan. 25.

CMS Acting Administrator Kerry Weems said the five new standards and revisions to seven existing standards “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. 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 CMS bulletin announcing the changes said they’re “expected to help ensure that only legitimate DMEPOS suppliers participate in Medicare.”

Among the proposed new standards:
•    Require DMEPOS suppliers to notify the NSC of any adverse legal action, change of location, and change of ownership. A supplier who fails to report the required information within 30 days would not be eligible to receive Medicare payments.
•    Prohibit suppliers from sharing a practice location with another Medicare supplier.
•    Require suppliers to maintain ordering and referring documentation received from the physician or other treating professional for seven years.
•    Prohibit DMEPOS suppliers that have a federal or state tax delinquency from obtaining billing privileges or retaining billing privileges they have already been granted.
•    Require suppliers to maintain a location or office at an appropriate site where they store business records and retain documentation of orders and referrals.
•    Require that the NSC (National Supplier Clearinghouse) be listed as a certificate holder on the comprehensive liability insurance policy.
•    Expand the existing limitation on when and how a supplier may contact Medicare beneficiaries.
•    Limit the use of cell phones, beeper numbers, pagers, and the exclusive use of answering machines and services as the primary business telephone number during posted hours of operation.
To view the entire proposed rule, go to the Federal Register Web site —
fr/index.html — then use search words “durable medical equipment orthotics prosthetics” in the Vol. 73 search field.

This article originally appeared in the March 2008 issue of Mobility Management.

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