Most suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) were required to have met new quality standards by October 1, 2009, and obtain a surety bond by October 2, 2009, as required by the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) and the Balanced Budget Act of 1997 (BBA).
In order to obtain Medicare billing privileges, DMEPOS suppliers must become accredited by meeting Medicare's business and product-specific service and quality standards. The business standards include: (1) how the company is run, (2) how finances and staff performance are managed, (3) how well the company takes care of its consumers, (4) the safety of their products, and (5) whether the company’s information management systems are in place. The product-specific service standards include: (1) intake, (2) delivery and setup, (3) training and instruction of the beneficiary and their caregiver, and (4) follow-up service.
According to CMS, the vast majority of Medicare DMEPOS suppliers have met the deadlines to apply and become accredited. CMS is continuing to work to complete the evaluations of those suppliers whose accreditation applications are still under review, which could take as long as 60 days. Suppliers wishing to participate in the Medicare DMEPOS competitive bidding program must be fully accredited to submit a bid.
CMS-deemed accreditation organizations have been required by the MMA to use these new quality standards to evaluate the applications of thousands of DMEPOS suppliers during the past three years. More than 50,000 DMEPOS suppliers (70 percent) have already been accredited.
The accreditation requirement applies to suppliers of durable medical equipment, medical supplies, home dialysis supplies and equipment, therapeutic shoes, parenteral/enteral nutrition, transfusion medicine and prosthetic devices, prosthetics and orthotics unless a professional exemption applies. Pharmacies, pedorthists, mastectomy fitters, orthopedic fitters/technicians and athletic trainers must also comply.
Congress is considering extending the deadline for pharmacies to meet this accreditation requirement to January 1, 2010, with the exception of those pharmacies that plan to bid in the DMEPOS competitive bidding program.
The BBA surety bond requirement requires certain DMEPOS suppliers to obtain and maintain a $50,000 surety bond. The surety bond limits the risk to the Medicare program from fraudulent equipment suppliers and helps to ensure that Medicare beneficiaries receive medical items that are “reasonable and necessary” from legitimate suppliers.
Source: CMS Fact Sheet, Oct. 1, 2009.
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