-
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 non-procurement 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.
-
All DMEPOS
suppliers must obtain a surety bond in order to receive and
retain a supplier billing number.