Medicare Compliance & Reimbursement

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 orthotics supplier who called into the forum.

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

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.

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 MLR. But applications "shouldn't be rejected when they follow all the rules," he insists.