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Home > Terms, Conditions and Policies > Medicare DMEPOS Supplier Guide
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- A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
- A
supplier must provide complete and accurate information on the DMEPOS
supplier application. Any changes to this information must be reported
to the National Supplier Clearinghouse within 30 days.
- An authorized individual (one whose signature is binding) must sign the application for billing privileges.
- A
supplier must fill orders from its own inventory, or must contract with
other companies for the purchase of items necessary to fill the order.
A supplier may not contract with any entity that is currently excluded
from the Medicare program, any State health care programs, or from any
other Federal procurement or nonprocurement programs.
- A supplier must advise
beneficiaries that they may rent or purchase inexpensive or routinely
purchased durable medical equipment, and of the purchase option for
capped rental equipment.
- A supplier must notify
beneficiaries of warranty coverage and honor all warranties under
applicable State law, and repair or replace free of charge Medicare
covered items that are under warranty.
- A supplier must maintain a physical facility on an appropriate site.
- A
supplier must permit CMS, or its agents to conduct on-site inspections
to ascertain the supplier’s compliance with these standards. The
supplier location must be accessible to beneficiaries during reasonable
business hours, and must maintain a visible sign and posted hours of
operation.
- A supplier must maintain a
primary business telephone listed under the name of the business in a
local directory or a toll-free number available through directory
assistance. The exclusive use of a beeper, answering machine or cell
phone is prohibited.
- A supplier must have
comprehensive liability insurance in the amount of at least $300,000
that covers both the supplier’s place of business and all customers and
employees of the supplier. If the supplier manufactures its own items,
this insurance must also cover product liability and completed
operations.
- A supplier must agree not
to initiate telephone contact with beneficiaries, with a few exceptions
allowed. This standard prohibits suppliers from calling beneficiaries
in order to solicit new business.
- A supplier is responsible
for delivery and must instruct beneficiaries on use of Medicare covered
items, and maintain proof of delivery.
- A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.
- A
supplier must maintain and replace at no charge or repair directly, or
through a service contract with another company, Medicare-covered items
it has rented to beneficiaries.
- A supplier must accept
returns of substandard (less than full quality for the particular item)
or unsuitable items (inappropriate for the beneficiary at the time it
was fitted and rented or sold) from beneficiaries.
- A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.
- A supplier must disclose to the government any person having ownership, financial, or control interest in the supplier.
- A
supplier must not convey or reassign a supplier number; i.e., the
supplier may not sell or allow another entity to use its Medicare
billing number.
- A supplier must have a
complaint resolution protocol established to address beneficiary
complaints that relate to these standards. A record of these complaints
must be maintained at the physical facility.
- Complaint records must
include: the name, address, telephone number and health insurance claim
number of the beneficiary, a summary of the complaint, and any actions
taken to resolve it.
- A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.
- All
suppliers must be accredited by a CMS-approved accreditation
organization in order to receive and retain a supplier billing number.
The accreditation must indicate the specific products and services, for
which the supplier is accredited in order for the supplier to receive
payment of those specific products and services (except for certain
exempt pharmaceuticals).
- All suppliers must notify their accreditation organization when a new DMEPOS location is opened.
- All
supplier locations, whether owned or subcontracted, must meet the
DMEPOS quality standards and be separately accredited in order to bill
Medicare.
- All suppliers must disclose
upon enrollment all products and services, including the addition of
new product lines for which they are seeking accreditation.
- Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c).
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Palmetto GBA
National Supplier Clearinghouse
P.O. Box 100142 . Columbia, South Carolina . 29202-3142 . (866) 238-9652
A CMS Contracted Intermediary and Carrier |
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