MIR-2007-5B, May 2007

Accreditation Information for Suppliers of Durable Medical Equipment, Orthotics, Prosthetics, and Supplies (DMEPOS)

Provider Types Affected
All suppliers of durable medical equipment (DME) that wish to participate in the Medicare DMEPOS program

Provider Action Needed
This Special Edition (SE) article, SE0713, provides the information that DME suppliers need to comply with Section 302(b)(1) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). That MMA section requires the Secretary of the Department of Health and Human Services (HHS) to establish and implement quality standards for DMEPOS suppliers. All DMEPOS suppliers wishing to bill Medicare for DMEPOS provided to Medicare patients must comply with these standards to receive Medicare Part B payments. In addition, Section 1847 (b)(2)(A)(i) of the Social Security Act requires DMEPOS suppliers meet these standards before being awarded a contract under the upcoming Medicare DMEPOS Competitive Bidding Program.

Background
Section 302 of the MMA required the Secretary to establish and implement quality standards for suppliers of DMEPOS. All suppliers of DMEPOS must comply with the quality standards in order to receive Medicare Part B payments and to retain a supplier billing number. Covered items include (Section 1834 (a) (13 and (h) (4)):

• Medical supplies;
• Home dialysis supplies and equipment;
• Therapeutic shoes;
• Parenteral and enteral nutrient, equipment and supplies;
• Electromyogram devices;
• Salivation devices;
• Blood products;
• Transfusion medicine; and
• Prosthetic devices, orthotics.

The standards will be applied prospectively and are published at http://www.cms.hhs.gov/Medicareprovidersupenroll on the Centers for Medicare & Medicaid Services (CMS) Web site. Also, note that Section 1847(b)(2)(A)(i) of the Act requires DMEPOS suppliers to meet the quality standards before being awarded a contract under the Medicare DMEPOS Competitive Bidding Program.

The quality standards are separated into two sections and have three appendices, as follows:

• Section I includes the business standards that apply to all suppliers and focus on standards for administration, financial management, human resource management, consumer services, performance management product safety, and information management.
• Section II contains product-specific service standards, including intake, delivery and setup, training and instruction of the beneficiary and/or their caregiver, and follow-up service.
• Appendix A deals with respiratory equipment, supplies, and services.
• Appendix B deals with manual wheelchairs and power mobility devices, including complex rehabilitation and assistive technology.
• Appendix C deals with custom fabricated, custom fitted and custom made orthotics, prosthetic devices, somatic, ocular and facial prosthetics, and therapeutic shoes and inserts.

In order to participate in Medicare Part B, DMEPOS suppliers will need to be accredited and in compliance with these standards. The accreditation will be phased in and to accommodate the suppliers who wish to participate in the Medicare Competitive Bidding Program for DMEPOS, CMS will require accreditation organizations to prioritize their surveys of suppliers to accredit suppliers in the selected Metropolitan Statistical Areas (MSA) where the Bidding Program will begin. To provide additional information on the accreditation surveys, suppliers should note that:

• All surveys are performed on site at the supplier location.
• All surveys are unannounced.
• Accreditation cannot be transferred upon merger, acquisition or sale – CMS, the National Supplier Clearinghouse (NSC) and the Accreditation organization must be notified when these events occur.
• The Accreditation organization and the NSC will be coordinating efforts so that the supplier number can be revoked when accreditation is revoked.

Status of Accreditations

• Almost 5,000 suppliers are already accredited (329 of those are in the 20 MSAs proposed in the NPRM for the Competitive Bidding Program).
• 1,000 surveys have been scheduled since the start of 2007.
• Ten (10) Accreditation Organizations were deemed by CMS in Nov. 2006. Those organizations are listed at http://www.cms.hhs.gov/CompetitiveAcqforDMEPOS/downloads/DMEPOS_Accreditation_Organizations.pdf on the CMS Web site.

Suppliers can contact the deemed accrediting organizations directly based on the information provided at that Web site.

Additional Information
The CMS complete listing of all DME resources is available at http://www.cms.hhs.gov/center/dme.asp on the CMS Web site.

Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.

MLN Matters Number: SE0713
Related Change Request (CR) #: N/A
Effective Date: N/A

The Medicare Guide to Rural Health Services: Information for Providers, Suppliers, and Physicians (Second Edition), which provides rural information pertaining to rural health facility types, coverage and payment policies, and rural provisions under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 and the Deficit Reduction Act of 2005 is now available in downloadable format at http://www.cms.hhs.gov/MLNProducts/downloads/MedicareRuralHealthGuide.pdf .