Join us at Medtrade in Dallas, TX from March 28-30, 2023, at the Kay Bailey Hutchison Convention Center. Medtrade is the largest home medical equipment (HME) trade show and conference in the US and includes a large expo floor filled with the leading home medical equipment manufacturers and HME technology. Beyond the expo floor, attend conference sessions covering numerous topics presented by HME industry leaders.
Stop by Booth 456 to see your Medicare contractors and ask questions! We will have representation from the:
DME Medicare Administrative Contractors (DME MACs)
Competitive Bidding Implementation Contractor (CBIC)
Common Electronic Data Interchange (CEDI) contractor
Pricing, Data Analysis, and Coding (PDAC) contractor
National Provider Enrollment contractors (NPEAST and NPWEST)
The exhibition hall is open from 9 am – 5 pm CT on Wednesday, March 29 and from 9 am – 5 pm CT on Thursday, March 30.
The “Medicare Updates” track is open to all conference and expo attendees! The DME MACs will present two sessions under this track:
March 28, 2023, 10:15 am – 11:15 am: Medicare & CERT Task Force Updates. Provider Outreach and Education representatives from the four DME MACs will provide an update on the most current Comprehensive Error Rate Testing (CERT) data, educational updates, and more.
March 29, 2023, 10:15 am – 11:15 am: The NPWEST Program Manager and NPEAST Project Manager will present “The New (but not that different) Medicare DMEPOS Enrollment” to discuss DMEPOS enrollment after implementation of the NPE contracts.
March 30, 2023, 10:15 am – 11:15 am: Medicare Auditing Entities. This session outlines the purpose of Medicare review programs and the different auditing entities involved. Attendees will learn strategies for responding to documentation requests and next steps for unfavorable audit decisions.
Register now, and we look forward to seeing you there!
Eligible suppliers must use the revised CMS-855S (Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers) application beginning January 9, 2023. The revised application will be posted on the CMS Forms List (CMS Forms List | CMS) by late December.
National Provider Enrollment DME Contractors (NPEs) will accept the current and revised versions of the CMS-855S through April 7, 2023. After April 7, 2023, only the revised application will be accepted. Visit the Medicare Provider Enrollment and Certification webpage (Provider Enrollment and Certification | CMS) for more information about Medicare enrollment.
Changes to the form include:
Added medical record correspondence address to section 4B2
Revised section 2E: Products and accreditation Information to collect whether the supplier fills orders, fabricates, or fits items by contracting with other companies.
It is imperative that your ownership information is consistent across all enrollment records under one tax identification number (TIN). If an individual or organization has 5% or more partnership or indirect/direct ownership in your organization, they must be listed on all enrollment records under your TIN.
If your enrollment records show a difference in ownership, CMS will be mailing you a letter which explains that we will use the ownership information from the most recent application with an ownership change and apply this information to all enrollment records under the same TIN.
If you need to perform a change of information to update your ownership information, you can submit an application online through PECOS or download a paper-based application. Going forward, any application received that changes the ownership information will be applied to all enrollment records under the same TIN.
For more information, please visit CMS MLN Connects.
Coming Summer 2023, PECOS will undergo a redesign to introduce PECOS 2.0. This update will allow:
A single application for multiple enrollments
Pre-population of data and an application that’s tailored to the provider/supplier
Enhanced capability to add or delete group members
Real-time processing checks and status updates
The following links were posted by CMS to provide additional information to the provider community regarding the updates:
Note: Continue to check the CMS PECOS links enrollment section for PECOS 2.0 updates.
Physicians and practitioners are typically required to submit claims on behalf of beneficiaries for items and services they provide that may be covered under Medicare Part B. Certain types of physicians and practitioners may opt-out of Medicare. To properly opt-out, an opt-out affidavit must be filed with the MAC that has jurisdiction over claims the physician or practitioner would file with Medicare.
Note: DMEPOS suppliers of services, or a physician or practitioner owner of such suppliers, are not eligible to opt-out.
The NPEAST DMEPOS does not process opt-out affidavits. If you are interested in opting out of the Medicare program, be sure you submit the request to your A/B MAC. To find out who your MAC is, visit CMS’ Who are the MACs webpage. To learn more about opting out of the Medicare program, visit the Program Integrity Manual Pub. 100-08, Chapter 10, section 10.6.12.
MLN Matters article MM12865, Provider enrollment: Regulatory changes
The Medicare Participation Physicians/Suppliers Directory (MEDPARD) is available at Durable Medical Equipment Cost Compare | Medicare.gov. Search on the Supplier Directory by zip code and equipment (optional) to find a supplier. The search results will indicate if the supplier is participating with Medicare (accepts assignment). There will be no hardcopy distribution of the directory.
Suppliers must meet requirements to enroll in the Medicare program as a durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier. This includes meeting DMEPOS supplier standards. The DMEPOS supplier standards can be located 42 C.F.R. section 424.57(c).
Standard 10 requires all DMEPOS suppliers have comprehensive liability insurance in the amount of at least $300,000 (for each incident) and the insurance must remain in force at all times.
Per guidance from the CMS and in an effort to protect the Medicare trust fund by ensuring supplier standards are met, the NPEAST DMEPOS contractor will contact the insurance agent to verify the policy is active and current with a CMS-855S application submission.
Please ensure your insurance agent replies to verification requests in a timely manner to aid in the processing of DMEPOS applications.