Important Medicare Information about DMEPOS Supplier Accreditation and the Round 1 Rebid of the DMEPOS Competitive Bidding Program
MLN Matters® Number: SE0925 Revised
Related Change Request (CR) #: N/A
Related CR Release Date: N/A
Effective Date: N/A
Related CR Transmittal #: N/A
Implementation Date: N/A
Note: This article was revised on September 28, 2009, to include (and emphasize) on page 3 an important section regarding voluntary and non-voluntary terminations/enrollments.
Provider Types Affected
This article is for all suppliers that furnish Medicare Part B durable medical equipment, prosthetic devices, prosthetic or orthotic items and supplies (DMEPOS) to Medicare beneficiaries. Critical changes are coming that will affect the way Medicare pays for DMEPOS and how Medicare determines who can bill for DMEPOS. This article provides important reminders about some of these changes, which will be occurring in the very near future and how these changes affect suppliers who will participate in the DMEPOS competitive bidding program.
Suppliers are urged to review this article and be sure they are prepared for these changes in order to continue providing DMEPOS to Medicare patients.
Provider Action Needed: STOP – Impact to You
The Centers for Medicare & Medicaid Services (CMS) reminds Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) suppliers enrolled with the National Supplier Clearinghouse (NSC) they are required to obtain accreditation by October 1, 2009, unless exempt, and obtain a surety bond by October 2, 2009. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS will not accept bids from and will not contract with suppliers that are not accredited by a CMS-approved accreditation organization for the applicable product categories.
CAUTION – What You Need to Know
If you have made the decision not to obtain accreditation or a surety bond when required, you may want to voluntarily terminate your enrollment in the Medicare program before the implementation dates above. Voluntary termination allows you to re enroll once you meet the requirements to participate in the Medicare program. If you do not comply with the accreditation and surety bond requirements and do not submit a voluntary termination, your Medicare billing privileges will be revoked. A revocation will bar you from re-enrolling in Medicare for at least one year after the date of revocation.
GO – What You Need to Do
Whether or not you plan to remain as a Medicare supplier, it is recommended that you review this information. Suppliers who do not plan to stay enrolled in Medicare are strongly encouraged to notify their beneficiaries as soon as possible so the beneficiary can find another supplier.
Background
This article includes important reminder information for suppliers who will continue to serve as suppliers for Medicare beneficiaries on and after October 1, 2009.
Voluntary and Non-Voluntary Terminations/Enrollment
Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), unless exempt, must be accredited and obtain a surety bond by October 1, 2009 and October 2, 2009, respectively.
If you have made the decision not to obtain accreditation or a surety bond when required, you may want to voluntarily terminate your enrollment in the Medicare program before the implementation dates above. You can voluntarily terminate your enrollment with the Medicare program by completing the sections associated with voluntary termination on page 4 of the Medicare enrollment application (CMS-855S). Once complete, you should sign, date and send the completed application to the National Supplier Clearinghouse (NSC). By voluntarily terminating your Medicare enrollment, you will preserve your right to re-enroll in Medicare once you meet the requirements to participate in the Medicare program.
If you do not comply with the accreditation and surety bond requirements and do not submit a voluntary termination, your Medicare billing privileges will be revoked. A revocation will bar you from re-enrolling in Medicare for at least one year after the date of revocation.
Suppliers who do not plan to stay enrolled in Medicare are strongly encouraged to notify their beneficiaries as soon as possible so the beneficiary can find another supplier.
Accreditation
In a previous MLN Matters® article, SE 0903, CMS informed suppliers of the importance of accreditation and the consequences of not being accredited on or before September 30, 2009. That article is at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0903.pdf (PDF, 104 KB) on the CMS Web site.
If you have already been notified by an approved accrediting organization that each of your practice locations has been accredited, the accreditation organization will notify the NSC that your DMEPOS supplier practice locations have been accredited. However, DMEPOS suppliers who obtained accreditation after September 1, 2009 but before October 1, 2009, should submit proof of accreditation to the NSC via submission of an amendment to their CMS-855S.
Further information on the DMEPOS accreditation requirements along with a list of the accreditation organizations and those professionals and other persons exempted from accreditation may be found at
Accreditation and DMEPOS Competitive Bidding
Suppliers choosing to participate in the DMEPOS Competitive Bidding Program must be accredited for a product category in order to submit a bid for that product category. CMS will not accept bids from and will not contract with suppliers that are not accredited by a CMS-approved accreditation organization for the applicable product categories.
- GET LICENSED: Suppliers submitting a bid for a product category in a competitive bidding area (CBA) must meet all DMEPOS state licensure requirements and other applicable state licensure requirements, if any, for that product category for every state in that CBA. Prior to submitting a bid for a CBA and product category, the supplier must have a copy of the applicable state licenses on file with the National Supplier Clearinghouse (NSC). As part of the bid evaluation, CMS will verify with the NSC that the supplier has on file a copy of all applicable required state license(s).
- GET ACCREDITED: Medicare DMEPOS suppliers, unless exempt, must be accredited by October 1, 2009. Suppliers must be accredited for a product category in order to submit a bid for that product category. CMS will not accept bids from and will not contract with suppliers that are not accredited by a CMS-approved accreditation organization for the applicable product categories.
- GET BONDED: Medicare DMEPOS suppliers, unless exempt, must obtain and submit a surety bond by October 2, 2009. Suppliers subject to the bonding requirement must be bonded in order to bid in the DMEPOS competitive bidding program. A list of surety companies from which a bond can be secured is found at the Department of the Treasury’s “List of Certified (Surety Bond) Companies;” the Web site is located at www.fms.treas.gov/c570/c570_a-z.html on the Internet. When submitting your DMEPOS surety bond to the NSC, you are required to submit sections 1, 2A1, 12, and either 15 (if you are the AO) or 16 (if you are the delegated official) of the CMS-855S. By submitting the required sections of the CMS-855S, you will help to ensure that NSC is able to correctly associate your DMEPOS surety bond to your enrollment record.
Accessing the Processes for the Round 1 Rebid
On August 3, 2009 CMS issued the bidding timeline for the Round 1 Rebid of the DMEPOS competitive bidding program and initiated a comprehensive bidder education campaign. The CMS contractor, CBIC, is the focal point for bidder education. Please visit the CBIC's dedicated Web site, http://www.dmecompetitivebid.com/, for important information, including bidding rules, user guides, frequently asked questions, policy fact sheets, checklists, and bidding information charts. The CBIC toll-free help desk, 1-877-577-5331, is open to help bidders with all of their questions and concerns. All suppliers interested in bidding are urged to sign up for e-mail updates on the home page of the CBIC Web site. The Round 1 Rebid will result in significant changes in the way Medicare pays for certain types of DMEPOS and it is critical that suppliers understand the process and what it takes to be eligible to bid.
In prior communications, CMS has described the processes for registering to use CMS systems. (See the MLN Matters® article, SE 0915, at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0915.pdf (PDF, 75 KB) on the CMS Web site.) For the Round 1 Rebid, it is imperative that suppliers register so they will be able to participate in the bidding process for the categories of DMEPOS to be obtained only through the competitive bidding program.
Round 1 Rebid Registration Milestones
Suppliers should be well into, if not completely through, this registration process. Registering now allows the AO and/or BAO time to correct the supplier’s NSC records if their name, date of birth, and SSN does not match what is on file with NSC. CMS recommends that BAOs register no later than October 9, 2009, so that they will be able to assist AOs with approving EU registration. Registration will close on November 4, 2009, at 9:00 p.m. EST – no AOs, BAOs, or EUs can register after registration closes. The legal name, date of birth, and Social Security number (SSN) of the AO and BAOs must match what is on file with the NSC in order to register successfully. To register, go to www.dmecompetitivebid.com/ on the Competitive Bidding Implementation Contractor (CBIC) Web site.
- A registration checklist
- Quick Step guides; and frequently asked questions
- All suppliers interested in bidding are urged to sign up for E-mail Updates on the home page of the CBIC Web site. If you have any questions about the registration process, please contact the CBIC Customer Service Center at (877) 577-5331.
The target deadline for Authorized Officials interested in participating in the Round 1 Rebid to register was September 14, 2009. If you are an AO who has not yet registered – do it TODAY! Visit www.dmecompetitivebid.com/ to register.
Additional Information
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.