In simultaneous announcements distributed by all four DME MACs, the Centers for Medicare & Medicaid Services (CMS) has announced a change to the refill requirements for DMEPOS items and supplies provided on a recurring basis. The new requirements cover a number of different types of DMEPOS including but not limited to CPAP.
CMS will now require that the supplier contact the beneficiary no sooner than 14 calendar days prior to delivering or shipping new equipment or supplies. Refills cannot be provided on an automatic or pre-determined basis. Suppliers are to document contact with the beneficiary to confirm need of new supplies or equipment by either a written request from the beneficiary, or by documenting either a phone call or in-person encounter. The announcement goes on to indicate that for non-consumable supplies such as CPAP, the supplier must assess whether the supplies are still functional prior to providing a replacement or refill.
The complete announcements from the four DME MACs are linked below:
Jurisdiction A – NHIC Announcement
Jurisdiction B – National Government Services Announcement
Jurisdiction C – CGS Announcement
Jurisdiction D – Noridian Announcement