May 1, 2009, Home Health & Hospice Medicare A Newsline - CGS

Provider Action NeededSTOP – Impact to YouDMEPOS (durable medical equipment, prosthetics, orthotics and supplies) providers and suppliers enrolledin the Medicare Part B program are required to obtain accreditation by September 30, 2009.CAUTION – What You Need to KnowIn order to retain or obtain a Medicare Part B billing number, all DMEPOS providers and suppliers (exceptfor exempted professionals and other persons as specified by the Secretary of the Department of Health andHuman Services as noted below in this article) must comply with the Medicare program’s supplier standardsand quality standards and become accredited. A DMEPOS supplier’s Medicare Part B billing privilegeswill be revoked on October 1, 2009, if the DMEPOS supplier fails to obtain accreditation by September 30,2009.GO – What You Need to DoDMEPOS providers and suppliers that have not yet done so should contact an accreditation organization(AO) right away to obtain information about the accreditation process and submit an accreditationapplication to the AO of their choosing. Suppliers can find a list of the deemed accrediting organizations athttp://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/DeemedAccreditationOrganizations.pdfon the CMS Web site.BackgroundSection 302 of the Medicare Modernization Act of 2003 (MMA) added a new paragraph 1834(a)(20) to theSocial Security Act (the Act) that required the Secretary to establish and implement quality standards forsuppliers of DMEPOS. All suppliers that furnish such items or services set out at subparagraph1834(a)(20)(D) as the Secretary determines appropriate must comply with the quality standards in order toreceive Medicare Part B payments and to receive or retain a provider or supplier number.Covered Items and ServicesPursuant to subparagraph 1834(a)(20)(D) of the Act, the covered items and services are defined in Section1834(a)(13), Section 1834(h)(4) and Section 1842(s)(2) of the Act. The covered items and services include:• Durable Medical Equipment (DME);• Medical supplies;• Home dialysis supplies and equipment;• Therapeutic shoes;• Parenteral and enteral nutrient, equipment and supplies;• Blood products;• Transfusion medicine; and• Prosthetic devices, prosthetics, and orthotics.Non-Covered Items• Medical supplies furnished by home health agencies;• Drugs used with DME (inhalation drugs and drugs infused with a DME pump);• Implantable items and;• Other Part B drugs:• Immunosuppressive drugs• Anti-emetic drugs.Home Health & Hospice May 1, 2009 16Medicare A Newsline Vol. 16, No. 8