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Medicare Supplier Standards
- A supplier must be in compliance with all applicable Federal
and State licensure and regulatory requirements.
- 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.
- An authorized individual (one whose signature is binding) must
sign the application for billing privileges.
- 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.
- 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.
- 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.
- A supplier must maintain a physical facility on an appropriate
site.
- A supplier must permit HCFA, 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.
- 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 or cell phone is prohibited.
- 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.
- A supplier must agree not to initiate telephone contact with
beneficiaries, with a few exceptions allowed.
This standard prohibits suppliers from calling beneficiaries in
order to solicit new business.
- A supplier is responsible for delivery and must instruct beneficiaries
on use of Medicare covered items, and maintain proof of delivery.
- A supplier must answer questions and respond to complaints of
beneficiaries, and maintain documentation of such contacts.
- 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.
- 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.
- A supplier must disclose these supplier standards to each beneficiary
to whom it supplies a Medicare-
covered item.
- A supplier must disclose to the government any person having
ownership, financial, or control interest in the supplier.
- 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.
- 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.
- 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.
- A supplier must agree to furnish HCFA any information required
by the Medicare statute and implementing regulations.
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