DME Supplier with Medicare need to be accredited?

[Michele]

I had someone call me today to ask about becoming a DME supplier for Medicare.  Since they are not a physician I informed them of the new requirements of accreditation.  They then sent an email stating:

"I did want to clarify one aspect of what we do as a distributorship. We are in fact a distributor. However, we do not purchase product wholesale to keep on the shelf and sell to a practice. The products we sell are prescribed by doctors on a patient by patient basis. We are strictly the conduit for DJO to get the products to the patients. DJO primarily operates with direct sales reps, but we are one of the few distributors they work with."

This still requires accreditation correct?  (Charlene ?) 

Thanks
Michele

[Pay_My_Claims]

WHO SHOULD BECOME ACCREDITED?  Any DME supplier that provides equipment and services to Medicare beneficiaries will have to become accredited to continue receiving payment from Medicare.  Pharmacies that dispense any medical equipment, parenteral nutrition and/or transfusion medications must also become accredited.

DMEPOS SUPPLIER ACCREDITATION

In order to participate in Medicare Part B, certain DMEPOS suppliers will need to complete the accreditation process and be in compliance with new quality standards.

CMS announced that as of September 3, 2008, several supplier types are now exempt from all accreditation requirements. Among these supplier types are:

    * Physicians, including dentists
    * Orthotists
    * Prosthetists
    * Opticians
    * Optometrists
    * Audiologists
    * Occupational Therapists
    * Physical Therapists
    * Podiatrists

Pedorthists, mastectomy fitters, orthopedic fitters/technicians and athletic trainers shall require accreditation to obtain/maintain Medicare billing privileges.

Suppliers that fall in this subset are reminded that if they provide other DME outside of their specialty, they will be required to be accredited to bill Medicare.

In addition, suppliers that provide drugs and pharmaceuticals ONLY are exempt from the accreditation requirement. If the supplier provides equipment to administer drugs or pharmaceuticals, the supplier must be accredited.

As an exempted supplier, if your enrollment application was returned previously for non-accreditation, you must resubmit your 855S to the National Supplier Clearinghouse (NSC). Billing privileges will not be retroactive due to new accreditation exemptions.


I have no idea what this person is speaking about. DJO is ACHC accredited. I don't know if he is a middle man, like a drug runner or something, of if he is like a Vendor (Permobil, Sunrise, ) that sell to suppliers who then sell to clients. However unless he is exempt according to the Medicare guidelines, he has to be accredited.

[Michele]

So bottom line, if they are delivering the products to the Medicare beneficiaries they must be accredited, unless they qualify for exemption.

I thought so, but he confused me with that description.

Thanks
Michele

[Pay_My_Claims]

Yes if they are filing Medicare. He baffled me.