Medicare Update

In our efforts to keep you updated regarding the new Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Accreditation/Surety Bond Requirements, we wanted to share with you potential areas within North Dakota where a Medicare beneficiary may experience supplier access issues in obtaining certain DMEPOS. Additionally, were also providing you with some quick facts/resources regarding the program. If you have additional questions, please call Beverly Mendicello at 303-844-6337.



Supplier Access:

Medicare beneficiaries in North Dakota, may experience potential access issues for the following equipment/supply categories in the counties listed below. Keep in mind this information is subject to change because supplier accreditation is ongoing.



North Dakota
Affected Counties

Oxygen
Slope, Bowman, Adams, Emmons, McIntosh, Dickey, Hettinger, Grant, Sioux, Golden Valley & Logan

Enteral Nutrition
Adams, McIntosh, Dickey & Sargent

Parenteral Nutrition
McKenzie




For Assistance in Finding Another Supplier:

Beneficiaries should call 1-800-MEDICARE, that’s 1-800-633-4227, or visit www.medicare.gov and select “Find Suppliers of Medicare Equipment in Your Area – Supplier Look-up Tool.” On October 15, the Supplier Look-up Tool was updated with accredited and exempt suppliers only (including mail order companies). In order to ensure Medicare payment, beneficiaries should ask any new supplier they contact if they are still approved by Medicare to provide covered medical equipment and supplies.



Quick Facts:

· Starting October 1, 2009, new rules went into effect for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers in order to be paid by Medicare.



· The new requirements include being accredited and having a surety bond which will help assure that Medicare beneficiaries continue to get high-quality products and services and help to prevent fraud in the Medicare program.



· If a beneficiary’s supplier doesn’t meet these new requirements, the beneficiary will have to look for another Medicare-approved supplier in order for Medicare to pay for their equipment and supplies.



· If a beneficiary continues to get supplies from a supplier who has not met these requirements, Medicare won’t pay and the beneficiary may have to pay the full cost for the supplies.



· The new requirements affect the following types of DMEPOS suppliers:



• Durable medical equipment

(such as oxygen equipment and power wheelchairs)

• Medical supplies

(such as diabetic supplies - unless acquired at a pharmacy, thru 12/31/09)

• Home dialysis supplies and equipment

• Therapeutic shoes

• Parenteral/enteral nutrition

• Transfusion medicine

• Prosthetic devices

• Prosthetics and orthotics



· Although most suppliers will continue in the Medicare program, some have chosen not to stay enrolled.



· Beneficiaries should ask if their current supplier plans to meet these new Medicare program requirements to avoid any interruption in their services.



· For beneficiaries who are renting equipment, their current supplier should make arrangements to remove the equipment after the beneficiary has received replacement equipment from their new supplier.



· For more information, please reference the DMEPOS toolkit on cms.hhs.gov, which contains facts sheets, FAQs, and which has been recently updated with the beneficiary notification letter:

http://www.cms.hhs.gov/Partnerships/03_DMEPOS_Toolkit.asp#TopOfPage









Lucretia James

Division for Medicare Health Plans Operations
Centers for Medicare & Medicaid Services
Region VIII
1600 Broadway, Suite 700
Denver, CO 80202
(303) 844-1568
lucretia.james@cms.hhs.gov