CMS Proposes Changes to DMEPOS Supplier Standards

The Centers for Medicare & Medicaid Services (CMS) published a proposed rule earlier this month that would update the Medicare participation standards for suppliers of DMEPOS. The proposal would modify standards adopted in an August 27, 2010 final rule in a way that CMS believes promotes program integrity “but also addresses the realities that certain suppliers confront as they attempt to provide quality care and maintain access for beneficiaries.” Specifically, the proposed rule would:

  • Remove the definition of and modify requirements regarding “direct solicitation” that were included in the August 27, 2010 final supplier standard rule. CMS notes that it continues to be concerned about the potential for abuse caused by “direct solicitation” by DMEPOS suppliers and will continue to evaluate DMEPOS supplier marketing practice to protect beneficiaries. “Based upon our continuing need to evaluate these practices,” however, the agency believes that “further investigation is necessary to determine how the agency plans to address this concern.” On an interim basis, CMS intends ”to instruct Medicare contractors to continue applying the restrictions on telephone solicitation that were in effect before publication of the August 27, 2010 final rule, instead of implementing the final rule’s requirements regarding ‘direct solicitation.'”
  • Allow DMEPOS suppliers, including DMEPOS competitive bidding program contract suppliers, to contract with licensed agents to provide DMEPOS supplies unless expressly prohibited by state law (CMS notes that the absence of express state law has led to confusion about contracting rules).
  • Remove the requirement that DMEPOS suppliers comply with local zoning as part of the supplier standards. While suppliers still must comply with all applicable local zoning requirements, CMS would leave it to local municipalities to enforce zoning requirements.
  • Modify certain state licensing requirement exceptions to allow prosthetic and orthotic professionals to qualify for the minimum square footage exception if the state does not offer a licensure option. If a state does offer licensure for such professionals, however, the professionals would be required to obtain licensure in order to qualify for the exception to the minimum square footage requirement. CMS also would clarify that certain physical and occupational therapists are exempt from the minimum hours of operation requirement.

CMS will accept comments on the regulation until June 3, 2011.

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