Monthly Archives: February 2011

CMS Issues Proposed Rule on Rights of Beneficiaries to Make Complaints to Quality Improvement Organizations (QIOs)

On February 2, 2011, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule in the Federal Register, 76 FR 5755, that requires most Medicare providers and suppliers to provide written notice to beneficiaries of their right to lodge quality of care complaints with Quality Improvement Organizations (QIOs).

CMS contracts with a QIO in each state. QIOs are mostly private organizations staffed by health care professionals that CMS has trained to review the quality of medical care, help Medicare beneficiaries with complaints about care, and to implement improvements in the quality of care provided by Medicare providers and suppliers. CMS’ mission for the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. Continue reading

CMS Issues – MLN Matters on Expansion of Durable Medical Equipment (DME) Supplier Standards

On 2/1/2011, CMS Issued MLN Matters No. SE1032 entitled “Expansion of Durable Medical Equipment (DME) Supplier Standards” 

The article provides information for DMEPOS suppliers on the new expanded CMS enrollment standards that suppliers must meet in order to establish and/or maintain billing privileges in the Medicare Program. Continue reading

CMS Issues – MLN Matters on Expansion of Durable Medical Equipment (DME) Supplier Standards

On 2/1/2011, CMS Issued MLN Matters No. SE1032 entitled “Expansion of Durable Medical Equipment (DME) Supplier Standards” 

The article provides information for DMEPOS suppliers on the new expanded CMS enrollment standards that suppliers must meet in order to establish and/or maintain billing privileges in the Medicare Program. CMS advises that they have made the revisions in order to ensure that only legitimate DMEPOS suppliers participate in the Medicare program and are providing DMEPOS items to Medicare beneficiaries.

The new enrollment safeguards include:

  • Requirements for DMEPOS suppliers to obtain oxygen from a State-licensed oxygen supplier (applicable only to those suppliers in States that require oxygen licensure);
  • Requirements for DMEPOS suppliers to maintain ordering and referring documentation such as written orders from a physician or eligible professional;
  • A prohibition on DMEPOS suppliers from sharing a practice location;
  • Requirements for DMEPOS suppliers to remain open to the public for at least 30 hours a week with certain exceptions;
  • Requirements to notify the National Supplier Clearinghouse (NSC) of an adverse legal action, change of location, or change of ownership (including authorized and delegated officials) within 30 days;  
  • Revisions to  supplier standard 1 requiring the suppliers meet all state licensure and regulatory requirements.
  • Revisions to supplier standard 7 to ensure that the DMEPOS supplier maintains a physical facility on an appropriate site.

A copy of MLN Matters SE 1032 can be found here —->MLN Matters SE1032