FAQs

 


I recently purchased a DMEPOS company that was already accredited. With the change of ownership, is my business still accredited?

Answer:
Accreditation does not transfer with the acquisition of a DMEPOS business. If the old owner had accreditation, the new owner could be enrolled as of the date of sale. Suppliers are responsible to contact the accrediting organization within 30 days of the acquisition for further instruction and guidance.

This was last updated on 06/07/2019

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What is accreditation, and why is CMS requiring it for DMEPOS suppliers?

Answer:
Accreditation is the process by which an organization is authorized and credentialed. CMS requires DMEPOS Medicare suppliers to attain accreditation to ensure industry standards are met and to maintain high levels of excellence in service and supplies. As of October 1, 2009, all DMEPOS suppliers unless otherwise exempted by supplier type must be accredited by one of the nine CMS authorized accrediting organizations.

This was last updated on 06/07/2019

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What is the difference between supplier standards and quality standards?

Answer:
Suppliers must be in compliance with the current supplier standards to obtain and/or maintain Medicare billing privileges through the NSC. The supplier standards are published in CFR 42 424.57 (c).

The quality standards are guidelines used by the CMS approved accrediting organizations in which suppliers must comply to attain accreditation.

Suppliers are reminded that the NSC and the accrediting organizations are completely autonomous. Compliance with one entity does not guarantee compliance with the other.

This was last updated on 06/07/2019

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Accreditation FAQs (Subcontracting)

CMS has issued FAQs regarding accreditation requirements for subcontractors. Find attached the list of frequently asked questions.

This document contains attachments. Please open the full version to view or download.

This was last updated on 06/06/2019

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Are all DMEPOS suppliers required to be accredited?

Answer:
DMEPOS suppliers choosing to obtain/maintain Medicare billing privileges must submit accreditation documentation to the National Supplier Clearinghouse.

Those suppliers exempt from accreditation are:

  • Suppliers providing drug and pharmaceuticals only
  • Physicians, including dentists
  • Audiologists
  • Optometrists
  • Orthotists
  • Prosthetists, including occularists
  • Opticians
  • Occupational therapists
  • Physical therapists
Exempt suppliers are reminded that accreditation exemptions only extend to the normal scope of services for the supplier specialty. Any products or services provided outside the normal range of services will require accreditation to obtain/maintain Medicare billing privileges.

This was last updated on 06/06/2019

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How do I become accredited?

Answer:
CMS has approved nine organizations to oversee the process and determine if DMEPOS suppliers are meeting the requirements of the quality standards for accreditation. Suppliers are responsible to contact the organization and commence the accreditation process. Visit the organizations' websites to view a list of approved accrediting categories of products and services.

Approved Accrediting Organizations

This was last updated on 06/06/2019

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How should a supplier notify the NSC of their accreditation status?

Answer:
Accrediting organizations (AO) will report accreditation information to the National Supplier Clearinghouse (NSC). Suppliers may report accrediting information to the NSC by completing section 3B of the CMS 855S enrollment application. Suppliers should also complete sections 3A and 3D if accredited products or services are different from what the NSC has on file for the supplier. Other sections that should be submitted along with section 3B are sections 1B, 7, 11 and 15. Suppliers are encouraged to verify accrediting information with the AOs.

This was last updated on 06/06/2019

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I am supplying drugs and pharmaceuticals only. What information should I submit to the NSC?

Answer:
CMS has deemed that suppliers providing drugs and pharmaceuticals only are not required to be accredited to obtain/maintain Medicare billing privileges. If suppliers bill for DMEPOS outside of pharmaceuticals, including products to administer drugs or pharmaceuticals, accreditation will be required to maintain Medicare billing privileges.

Pharmacy suppliers choosing to provide pharmaceuticals only must update their file with the National Supplier Clearinghouse (NSC) to reflect the products and services that will be provided to Medicare beneficiaries. Sections that should be submitted to the NSC are 1A, 3A, 3B,3C, 11, and 14 or 15 of the CMS 855S enrollment form. Suppliers found to be in violation by billing for other products or services will be subject to appropriate actions up to and including revocation.

As of January 1, 2011, pharmacies that meet all criteria may file an accreditation exemption statement which enables them to be enrolled in Medicare to supply durable medical equipment, orthotics, prosthetics and supplies (DMEPOS) which require accreditation, without having an accreditation. The exemption criteria is attached.

This document contains attachments. Please open the full version to view or download.

This was last updated on 06/06/2019

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Contact NSC

Email National Supplier Clearinghouse

Contact a specific NSC department

Telephone: 866-238-9652

IVR: 866-238-9652

Address:

National Supplier Clearinghouse

Palmetto GBA, AG-495

P.O. Box 100142

Columbia, SC 29202-3142

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

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