CMSSS170913
Medicare Supplier Standards
1 . A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements and cannot contract with an individual or entity to provide licensed services .
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 . This standard requires that the location is accessible to the public and staffed during posted hours of business . The location must be at least 200 square feet and contain space for storing records .
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 , answering service or cell phone during posted business hours 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 contacting a Medicare beneficiary based on a physician ’ s oral order unless an exception applies .
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 ). Implementation Date October 1 , 2009
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
27 . A supplier must obtain oxygen from a state-licensed oxygen supplier .
28 . A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C . F . R . 424.516 ( f ).
29 . DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers .
30 . DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions .
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