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Non-Contract Suppliers

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If a beneficiary who resides in a competitive bidding area (CBA) changes from a Medicare Advantage (MA) Plan, either voluntarily or involuntarily, to Medicare fee-for-service (original Medicare), can he/she remain with his/her current managed care supplier even if the supplier is not a contract supplier for the specific competitively bid item the beneficiary receives from the supplier? Will Medicare continue to pay the supplier for the items and services?


07/30/2014
I am a supplier and want to buy or merge with a DMEPOS competitive bidding contract supplier. Can I make the change of ownership (CHOW) contingent upon CMS’ approval of a novation agreement?


05/10/2011
I am a non-contract supplier. If I buy or merge with a contract supplier, will CMS pay for contract items I furnish after the effective date of the change of ownership (CHOW) but before the date CMS signs the novation agreement?


05/09/2011
Do normal utilization parameters for accessories and supplies continue to apply when a patient transitions from a non-contract supplier to a contract supplier? For example, if a patient received a new continuous positive airway pressure (CPAP) mask in month six and transitioned to a contract supplier in month seven, is the contract supplier eligible to bill for a new mask upon setup? Can the contract supplier still provide these items, or is the patient not eligible since he or she received the mask in the month prior?


03/04/2011
If a patient using a continuous positive airway pressure (CPAP) device switches to a contract supplier during the 90-day trial period required by the Local Coverage Determination (LCD), does the contract supplier need to get the compliance data from the original provider?


03/04/2011
When a beneficiary transitions from a non-contract supplier to a contract supplier, does a new order need to be obtained by the contract supplier?


03/04/2011
When a beneficiary transitions to a contract supplier, would the contract supplier be required to have the patient repeat a facility-based sleep study?


03/04/2011
When a patient renting capped rental DME from a non-contract supplier switches to a contract supplier, a new 13-month rental payment period begins. Does the 90-day trial period required by the Local Coverage Determination (LCD) start over as well?


03/04/2011
Does the hospital exemption for the DMEPOS Competitive Bidding Program allow a hospital to bill for walkers furnished to its patients with Original Medicare on the day of an outpatient hospital service?Open in New Window

01/03/2011
If a beneficiary has been renting a competitively bid durable medical equipment (DME) item from a supplier that does not become a contract supplier and chooses to switch to a contract supplier at the start of a competitive bidding program, what month should the new contract supplier start billing? When can the non-contract supplier pick up its equipment?


10/19/2009
Who is responsible for repair and maintenance once an item is furnished?


10/01/2009


last updated on 07/30/2014

 

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