1. A supplier
must be in compliance with all applicable Federal and State licensure and
regulatory requirements.
2. 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.
3. An authorized
individual (one whose signature is binding) must sign the application for
billing privileges.
4. 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.
5. 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.
6. 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.
7. A supplier
must maintain a physical facility on an appropriate site.
8. 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.
9. 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.
10. 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.
11. 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.
12. A supplier
is responsible for delivery and must instruct beneficiaries on use of Medicare
covered items, and maintain proof of delivery.
13. A supplier
must answer questions and respond to complaints of beneficiaries, and maintain
documentation of such contacts.
14. 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.
15. 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.
16. A supplier
must disclose these supplier standards to each beneficiary to whom it supplies a
Medicare-covered item.
17. A supplier
must disclose to the government any person having ownership, financial, or
control interest in the supplier.
18. 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.
19. 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.
20. 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.
21. A supplier
must agree to furnish CMS any information required by the Medicare statute and
implementing regulations.
22. 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).
23. All
suppliers must notify their accreditation organization when a new DMEPOS
location is opened.
24. All supplier
locations, whether owned or subcontracted, must meet the DMEPOS quality
standards and be separately accredited in order to bill Medicare.
25. All
suppliers must disclose upon enrollment all products and services, including the
addition of new product lines for which they are seeking accreditation.
26. Must meet the surety
bond requirements specified in 42 C.F.R. 424.57(c). Implementation date- May 4,
2009
