New Durable Medical Equipment, Prosthetics, Orthotics and Supplier Standards May Require Operational Changes

Hinshaw Health Law Alert

September 21, 2010
Hinshaw Health Law Alert

On August 27, 2010, the Centers for Medicare & Medicaid Services (CMS) published a final rule titled, “Medicare Program; Establishing Additional Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Enrollment Safeguards” in the Federal Register (75 Fed. Reg. 52629). The final rule becomes effective September 27, 2010. 

That final rule introduces several new enrollment standards, and clarifies and expands on the existing enrollment requirements that DMEPOS suppliers must meet to establish and maintain billing privileges in the Medicare program. Many of the new requirements may require DMEPOS suppliers to review and revise their operations and/or policies and procedures to ensure compliance. Following is a summary of the new requirements that DMEPOS suppliers must follow:

In addition, the rule:

DMEPOS suppliers which do not meet the new requirements may have their Medicare provider numbers revoked. In addition, failure to comply with the rules could result in an overpayment, which could result in a false claim if not repaid in a timely fashion. To minimize their potential risks for failing to meet these new standards, DMEPOS suppliers should evaluate and update their existing operating practices, policies and procedures in response to the Final Regulations as well as the additional interpretive guidance included in the preamble to the Final Regulations. 

For further information, please contact Michael A. Dowell or your regular Hinshaw attorney.

This alert has been prepared by Hinshaw & Culbertson LLP to provide information on recent legal developments of interest to our readers. It is not intended to provide legal advice for a specific situation or to create an attorney-client relationship.

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