CMS Supplier Standards
CMS Supplier Standards
- 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
- 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
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. 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
- 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.
- 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.
- 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 contacting a Medicare beneficiary based on a physician's oral order unless
an exception applies.
- 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
- 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 CMS any information required by the Medicare
statute and implementing
- 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
- All suppliers must notify their accreditation organization when a new DMEPOS location
- All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality
standards and be separately accredited in order
- All suppliers must disclose upon enrollment all products and services, including
the addition of new product
lines for which they are seeking accreditation.
- Must meet the surety bond requirements
specified in 42 C.F.R. 424.57(c). Implementation date- May 4, 2009
- A supplier must obtain oxygen from a
state-licensed oxygen supplier.
- A supplier must maintain ordering
and referring documentation consistent with provisions found in 42 C.F.R. 424.516(f).
- DMEPOS suppliers are prohibited from sharing a practice location
with certain other Medicare providers
- DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain