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CAMPS Events & Education




California HME Update
Proposed File Format Conversion for Sections of the Medi-Cal Provider Manual

The Department of Health Care Services (DHCS) is proposing to reformat sections of the Medi-Cal Allied Health and Pharmacy provider manuals. The sections including, but not limited to, Contract Drug List, Enteral Nutrition Products, Incontinence Products and Medical Supply Products would be converted from the current Microsoft Word file format to Microsoft Excel file format to improve usability and to provide flexibility to searching and downloading product data.

Your input is important to help make the Provider Manuals more user friendly. Please take a minute to provide your feedback good or bad and any suggestions you may have by email to [email protected]

NAS DME Training in Concord, CA

 

When:                   

Tuesday, April 23, 2013

8:30 a.m. to 4:30 p.m.
Where:               
Hilton Concord Hotel
1970 Diamond Blvd
Concord, CA 94520
(925) 827-2000

 

The morning session includes

  • Intake Process
  • Preliminary and Written Orders
  • Certificate of Medical Necessity and DME Information Form
  • Medical Records
  • Continued Use and Continued Need
  • Advance Beneficiary Notice of Non-coverage
  • Proof of Delivery
  • Beneficiary Authorization / Signature on File
  • Comprehensive Error Rate Testing

The afternoon session will be roundtables focused on the following specialties. At the round tables, we will discuss common errors, reminders, resources, and questions.

  • Respiratory
  • Power Mobility Devices
  • Glucose Monitors and Testing Supplies

Attendees must preregister. To register, go to https://www.noridianmedicare.com/dme/train/workshops/face_to_face.html 

 

 
Grandfathering Option for Providers Who Didn't Win Bid

If your business was not a winning bidder for the Competitive Bid Round 2, then a letter should have been received from CMS outline what your options are.  It gives providers the option to become grandfathered so that you can be eligible to provide competitively bid items to Medicare beneficiaries within the designated CBA(s) in order to be reimbursed by Medicare.

 

What Does This Mean?

Non-contract suppliers that are renting competitively bid durable medical equipment (DME)* or oxygen and oxygen equipment at the time the DMEPOS Competitive Bidding Program is implemented may choose to become grandfathered suppliers for these items. A non-contract supplier that chooses to become a grandfathered supplier for any product category is required to grandfather all items within that product category to all Medicare beneficiaries who are renting the DME or oxygen and oxygen equipment at the time the program is implemented and who choose the grandfathering option. For Round 2, the program implementation date is July 1, 2013.

 

Notification Requirements 
Non-contract suppliers must provide written notification of their decision whether to be a grandfathered supplier to all of their Medicare beneficiaries who reside in a competitive bidding area (CBA) and are currently renting competitively bid DME or oxygen and oxygen equipment at least 30 business days prior to program implementation. The notification must inform the beneficiaries about their decision whether to grandfather and explain the grandfathering process and the beneficiaries' options.

 

Please see the Grandfathering for Rented DME and Grandfathering for Oxygen and Oxygen Equipment fact sheets for detailed information about grandfathering payment rules.

 

For more information you can also visit, http://www.dmecompetitivebid.com/palmetto/cbicrd2.nsf/docsCat/Round%202~Grandfathering%20Information~About%20Grandfathering?open.

 

* Rented DME items include power and manual wheelchairs, hospital beds, continuous positive airway pressure devices (CPAPs), negative pressure wound therapy pumps (NPWTs), respiratory assistive devices (RADs), support surfaces and walkers. Items in the enteral nutrients, equipment and supplies product category and the national mail-order program cannot be grandfathered.

 

 

 




One Capitol Mall, Suite 320
Sacramento, CA 95814 
t: (916) 443-2115 
f: (916) 444-7462