Medicare Compliance & Reimbursement

Low-volume suppliers of home medical equipment received a wake-up call in December -- a call they should quickly heed, experts say.

Any supplier of any item counted as durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) that bills Medicare Part B must secure accreditation come next fall in order to retain the right to serve Medicare beneficiaries.

That includes pharmacies and physicians, as well as other low-volume suppliers.

"If you are not accredited by Sept. 30, 2009, the National Suppliers Clearinghouse will revoke your billing privileges," said Centers for Medicare & Medicaid Services' (CMS) official Sandra Bastinelli, speaking at a Special Open Door Forum on Dec. 19 to announce the accreditation deadline (see story, page 1).

A number of callers during the forum represented pharmacies seeking clarification about possible exemptions from mandatory accreditation, particularly those with low Medicare billings.

"Some of these suppliers bill Medicare less than $30,000 or $40,000 annually," says Wayne Stanfield of the National Association of Independent Medical Equipment Suppliers.

Concern: The accreditation requirement will drive many pharmacies and other low-volume suppliers out of the Medicare program, creating access problems for beneficiaries, Stanfield and others predict.

Despite those concerns, CMS is forging ahead with the requirement -- and suppliers should expect them to continue their course.

"I was surprised by their surprise," says Josh Potter of PRS Pharmacy Services in Latrobe, PA, referring to the small suppliers who called into the forum hoping they'd be exempt from the mandatory accreditation deadline. "I think CMS has made it clear that there won't be any exemptions."