On October 21, 2009, CMS sent letters out to beneficiaries telling them that their Medical Equipment supplier "hasn't yet" met the new requirements to become Medicare-approved.  Starting October 1, 2009, the supplier can no longer bill Medicare for your medical equipment or supplies.  For a copy of the notification letter that is being sent out to beneficiaries along with additional information on Medicare's new accreditation and surety bond requirements for DMEPOS suppliers, go to:  
http://www.cms.hhs.gov/Partnerships/03_DMEPOS_Toolkit.asp#TopOfPage.
 
Several of our members reported their beneficiaries began receiving these letters over the past 10 days. To make matters worse, these suppliers have met both accreditation and bonding requirements and this has been verified by the NSC. But now, their phones have been ringing from concerned customers asking what is going on. This forces the supplier to have to notify all their Medicare patients that they have indeed met the requirements and that it is okay for them to continue to provide equipment and supplies.  Also, CMS is reaching out to Medicaid offices and other referral sources on this as well.
 
Senator Roberts of Kansas office has been contacted regarding this matter and his office contacted CMS.  However, CMS will not send out letters correcting the misinformation sent to beneficiaries whose Medical Equipment supplier was in compliance to state the previous letter was sent in error.
 
CMS is requesting that suppliers who feel their beneficiaries received these letters in error notify the NSC to verify that they are in compliance with accreditation and the surety bond requirements.  If the supplier finds that they were in compliance on October 1, 2009, CMS has told Senator Roberts office that they will send out the recension letter to their beneficiaries.
The CMS contact is Sandra Bastinelli at Sandra.Bastinelli@cms.hhs.gov or 410-786-3630.

CMS announced yesterday that they would delay until April 5 ,2010 the new PECOS requirement that would have required that the NPI of any referring or ordering physician/provider be included on the claim form or risk denial as of 1/4/2010. The complete notice is reprinted below.
 
The Centers for Medicare & Medicaid Services (CMS) will delay, until April 5, 2010, the implementation of Phase 2 of Change Request (CR) 6417 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors (MACs)) and CR 6421 (Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Supplier Claims Processed by Durable Medical Equipment Medicare Administrative Contractors (DME MACs)).  CRs 6417 and 6421 are applicable to Part B claims only.
 
The delay in implementing Phase 2 of these CRs will give physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers sufficient time to enroll in Medicare or take the action necessary to establish a current enrollment record in Medicare prior to Phase 2 implementation.
 
Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare.  A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner's National Provider Identifier (NPI).  Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected. 
 
CMS continues to urge physicians and non-physician practitioners who are enrolled in Medicare but who have not updated their Medicare enrollment record since November 2003 to update their enrollment record now.  If these physicians and non-physician practitioners have no changes to their enrollment data, they need to submit an initial enrollment application which will establish a current enrollment record in PECOS.
 
For physicians and non-physician practitioners who order or refer- 

 

If you are not enrolled in the Medicare program, or if you enrolled more than 6 years ago and have not submitted any updates or changes to your enrollment information in more than 6 years, you do not have an enrollment record in PECOS.  In order to continue to order or refer items or services for Medicare beneficiaries, you will have to submit an initial enrollment application.  You may do so either by (1) using Internet-based PECOS (which transmits your enrollment application to the Medicare carrier or A/B MAC via the Internet-be sure to mail the signed and dated Certification Statement to the carrier or A/B MAC immediately after submitting the application), or (2) filling out the appropriate paper Medicare provider enrollment application(s) (CMS-855I and CMS-855R, if appropriate) and mailing the application, along with any required additional supplemental documentation, to the local Medicare carrier or A/B MAC, who will enter your information into PECOS and process your enrollment application.  Information on how to enroll in Medicare is found on the Medicare provider/supplier enrollment web site at www.cms.hhs.gov/MedicareProviderSupEnroll.

If you are a resident who has a medical license but have not enrolled in Medicare because you would not be paid by Medicare for your services, you do not need to enroll in Medicare in order to continue to order or refer items or services for Medicare beneficiaries.  The teaching physician-not the resident-should be identified in claims as the ordering/referring provider when a resident orders or refers items or services for Medicare beneficiaries.
 
CMS actions to mitigate the number of informational messages: 
 
Since many Part B providers and suppliers are receiving a high volume of informational messages in their Remittances, CMS is taking the following actions to reduce the number of informational messages being generated: