Home Health & Hospice Week

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Supplier Number Process Sputters Back To Life

A select few will begin receiving their supplier numbers soon. 

"Don't call us, we'll call you." That's the attitude the Centers for Medicare & Medicaid Services seems to be taking about the preliminary lifting of the supplier number moratorium that will allow a select few durable medical equipment providers to obtain numbers ahead of the pack.

"CMS has authorized the National Supplier Clearinghouse (NSC) to begin submitting applications for new Medicare supplier numbers to CMS for approval," the NSC says in a Nov. 6 posting to its Web site.

"We're glad to see CMS is gearing up" to reinstate the supplier number issuance process, says Erik Sokol with the Power Mobility Coalition.

CMS will consider "expedited" review of the applications if they meet certain priority criteria, CMS said in the Nov. 5 Open Door Forum for home health. But the agency declined to outline what those criteria were, saying they were under review by CMS Administrator Tom Scully.

CMS officials did let slip some of the qualities that might land an application a quicker review:

  • An application already near completion (i.e., successful site visit already conducted) when CMS announced the moratorium Sept. 9.

  • Applicants that are "clearly beyond" the 21 supplier standards.

  • Reactivations. Suppliers with a Medicare track record should have an easier time convincing CMS of their legitimacy compared to brand new suppliers.

    Dealing in DME other than wheelchairs and scooters isn't a guaranteed ticket to receiving a supplier number more quickly. CMS has found other trouble spots in enrollment, including orthotics, an official told a Miami, FL orthotics supplier who called into the forum.

    Only cases of "extreme harshness" will make it into consideration for a fast-track review, Scully told listeners.

    Criteria Expected Soon

    The NSC will post the expedited process criteria on its Web site once they're approved, notes the American Association for Homecare. But at press time, the criteria were not on the site.

    That's probably because while the preliminary criteria outlined above have been roughed out, CMS still is developing other criteria that eventually will determine how long the supplier number process will take and how much scrutiny applications will receive, Sokol offers.

    CMS is taking its foot "gently and slowly off the brake" regarding supplier number issuances, Scully said. That means few providers will make the cut for speedy review. And "the approval process may still take some time because of the number of applications involved," the NSC cautions.

    Expedited numbers will start to come out only slowly, and suppliers whose applications are "problematic ... may not see something for some time," a CMS official said in the forum. Sokol doesn't expect to see the first numbers issued until January.

    Calling CMS or the NSC to plead for a fast turnaround is not going to magically get your name on the list. CMS told suppliers in October to contact their regional offices about getting in the running for an accelerated review, but now the agency isn't encouraging "more activity" on that front, an official said in the forum. "Suppliers are not required to take any actions other than ensuring that their applications are complete," the NSC adds.

    But the NSC does give out a toll free number for suppliers who have questions about their applications: 1-866-238-9652.

    AAH urges suppliers to go ahead and submit applications instead of holding them until the supplier number process is back to normal. The NSC continues to process applications, even though number issuances are held up.

    Industry Wants More Information 

    CMS says it's plugging along on policy changes related to Operation Wheeler Dealer, the fraud-fighting campaign that gave rise to the supplier number freeze. But when asked for more details in the forum, officials declined to divulge them.

    The PMC worries that CMS is narrowing the coverage criteria for wheelchairs, and therefore restricting access for certain beneficiaries, Sokol says. For example, new policies might limit coverage to patients with only certain diagnoses.

    Suppliers applying for numbers are seeing the same problem, and they're being punished for it, claims attorney Steve Azia with Washington, DC-based Eastwood & Azia. Of the many suppliers stuck in the freeze that Azia has heard from, a number are seeing their applications torpedoed because of new rules that haven't been announced, he contends. For example, the NSC appears to be denying applications if suppliers contract out for a respiratory therapist, although that's never been a problem before, he maintains.

    Suppliers are OK with the fact that CMS wants to get tougher on supplier applications, Azia tells Eli. But applications "shouldn't be rejected when they follow all the rules," he insists.