U S Department of Health and Human Services www.hhs.gov

Durable Medical Equipment (DME) Center

Spotlights
  • Medicare has announced new oxygen payment rules and supplier responsibilities required by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) in the Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B regulation (CMS-1403-FC). CMS will be issuing detailed program instructions and Medicare Learning Network (MLN) articles related to implementation of payment changes mandated by section 144(b) of MIPPA and section 5101 of the Deficit Reduction Act of 2005 within the next few months. View Regulation, Fact Sheet and Web Posting.
  • Medicare Solicits DMEPOS Competitive Bidding Program Advisory and Oversight Committee Members.  View Press Release and Federal Register Notice
  • Delay of the National DMEPOS Competitive Bidding Program: Claims Processing --  Section 154 of the Medicare Improvements for Patients and Providers Act of 2008 delays the DMEPOS Competitive Bidding Program. Therefore, in the 10 areas where competitive bidding was initiated, Medicare will pay for DMEPOS items, retroactive to June 30, 2008, using the standard DMEPOS fee schedule amounts.  CMS will begin processing all incoming claims under standard FFS rules, no later than July 28, 2008. Any claims that were held will be processed no later than August 4, 2008.  To the extent possible, CMS will also automatically reprocess claims that were paid under the Competitive Bidding Program and those claims denied based solely due to DMEPOS Competitive Bidding Program rules.  Note that in some instances suppliers will need to alert the contractor to claims that should be adjusted.  CMS will soon issue contractor instructions and issue accompanying MLN Matters articles with more information. (posted 7/18/08)
  • The Medicare Improvements for Patients and Providers Act of 2008 was enacted on July 15, 2008. This new law has delayed the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Items that had been included in the first round of the DMEPOS Competitive Bidding Program can be furnished by any enrolled DMEPOS supplier in accordance with existing Medicare rules. Payment for these items will be made under the fee schedule. Additional guidance regarding this new law will be forthcoming. (posted 7/16/08)

 

Medicare Learning Network (MLN) Spotlights

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Important Links





Medicare Prescription Drug Coverage



DME Medicare Administrative Contractor (MAC) Websites

Contacts

CMS Manuals & Transmittals

DME MAC Supplier Manuals


Coding

Program Integrity/ Medical Review
  • Chapter 5- Program Integrity Manual - Items and Services Having Special DMERC Review Considerations
  • Chapter 12- Program Integrity Manual - FI, Carrier, DMERC and RHHI Interaction and Coordination with Program Safeguard Contractors (PSCs)
  • Medical Review Process



 

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