On March 24, 2017, CMS issued Change Request 9886 titled Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Order Requirements for Changing Suppliers. This directive instructs contractors to accept prior orders and medical documentation after a change in supplier takes place. This eliminates the requirement for suppliers to procure new orders when a beneficiary changes suppliers. This instruction will take effect April 24, 2017.
In the wake of increased supplier transitions as a result of competitive bidding re-contracting, CMS has finally acknowledged that procuring new orders for a simple change in supplier created difficulties for beneficiaries seeking new suppliers. In doing so, they have directed contractors to accept orders and medical records from prior suppliers or physician offices.
In the wake of increased supplier transitions as a result of competitive bidding re-contracting, CMS has finally acknowledged that procuring new orders for a simple change in supplier created difficulties for beneficiaries seeking new suppliers. In doing so, they have directed contractors to accept orders and medical records from prior suppliers or physician offices.
Provided that a new supplier can procure valid and compliant documentation from another source, previously dated documents will support medical need for an item regardless of whether the documentation was furnished by the treating practitioner or by a previous supplier. However, if the new supplier is unable to procure documentation, or determines the documentation is not valid, a new order will be required. New orders are still required in the event an item is being replaced, or when an order for an item or accessory changes. MiraVista further recommends procuring annual orders to satisfy continued medical need.
Additional information is contained in a corresponding MLN Matters article. We’ll explore the impact of this directive on DME suppliers in our April edition of Vista Notes. If you are not a subscriber yet, what are you waiting for? Don’t want to miss another opportunity to get concise training in a convenient format for all of your staff. Vista Notes is produced every two months so you won’t be left behind!
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