CMS has cut doctors who offer Durable Medical Equipment (DME) breaks in the past. CMS excluded doctors who provide DME from the accreditation process and the expense of purchasing surety bonds (PBN 9/8/08, 4/6/09). But after Sept. 8, doctors will have to enroll as DME suppliers or stop offering DME to Medicare patients.
In Transmittal 297, CMS makes it clear that it wants to end arrangements where a practice keeps DME in stock, distributes DME to patients, but the DME supplier submits the bill. The practice will need to get its own DMEPOS number, purchase DME and bill the patient directly.
Healthcare experts point out this means more than the hassle of enrollment. A practice that enrolls as a DME supplier will have to learn a new set of rules, will be subject to on-site inspections and will need to make sure it isn't violating Stark self-referral rules.
Industry experts believe a change of this magnitude requires CMS to go through the rule making process complete with comment period. CMS counters that it's simply clarifying existing rules. Which opinion will prevail? Stay tuned.
On the Internet:
Program Integrity Manual, Transmittal 297