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Why is Accreditation Essential?
The Centers for Medicare and Medicaid Services established new requirements for suppliers and providers of DMEPOS which include custom-fabricated, custom-fitted, and pre-fabricated orthoses or splints. The Medicare Modernization Act (MMA) of 2003 was enacted into law for the purpose of determining payment for DEMPOS, controlling healthcare costs, ensuring quality healthcare services to Medicare beneficiaries, and limiting the burden on beneficiaries by reducing their out-of-pocket expenses. As a part of this Act, new Quality Business Standards were finalized in August 2006 to help ensure that:
- Medicare beneficiaries receive quality DMEPOS
- Providers and suppliers of DMEPOS are qualified
It is for these reasons that suppliers of DMEPOS must become accredited and that a competitive bidding process has been initiated.
Who Needs to Become Accredited?
CMS has announced that eligible professionals (which include Occupational Therapists and Physical Therapists) are exempt at this time from the mandatory accreditation requirement for DMEPOS suppliers. Thus, it is not necessary to become accredited in order to either maintain or obtain a National Supplier Clearinghouse number for DMEPOS.
Suppliers of durable medical equipment, prosthetics, and orthotics (who are not part of the exempt list) who bill under Medicare Part B must be accredited.
When Does a Supplier Need to be Accredited?
CMS has released the date of September 30, 2009 whereby all existing DMEPOS Suppliers who are not exempt need to be accredited in order to maintain their National Supplier Clearinghouse (NSC) number to bill DMEPOS. The NSC may revoke a DMEPOS supplier’s billing privileges if the DMEPOS supplier fails to obtain and submit supporting documentation that the DMEPOS supplier has been accredited.
More information can be found at the CMS website.
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