You have GOT to be kidding me.
by Caleb Reading
I previously wrote here and here about the situation with DMEPOS and billing diabetic testing supplies through Medicare and Medicaid. To boil it down, I work in a little independent pharmacy in an underserved community. We’re the only ones who stock diabetic testing supplies for miles around, and we live in the kind of climate where getting things through the mail can be questionable sometimes. We lose at least a couple bucks every time we bill test strips because neither Medicare/Medicaid nor private insurers want to pay us what they cost us. We supply them anyway, constantly losing money on them, because our patients need them. Well, not anymore. Now Medicare/Medicaid is going to make us pay thousands of dollars every three years to get DMEPOS accreditation to sell these supplies, even though 17 other medical professions are conditionally exempted. Well, it just gets weirder and weirder.
On January 2, 2009, the Centers for Medicare & Medicaid Services (CMS) published a final rule imposing surety bond requirements on certain Medicare suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). Specifically, suppliers generally will be required to post a $50,000 surety bond from an authorized surety, unless (1) the supplier is a high-risk supplier, in which case the bond amount will be increased, or (2) the supplier qualifies for an exemption from the surety bond requirement. A separate surety bond will required for each NPI obtained for DMEPOS billing purposes. […] Despite requests by commenters, CMS did not establish exceptions for pharmacies or for nursing facilities that bill for Medicare DMEPOS services provided to their own residents.
The surety bond is due by May 4th, 2009. It’ll cost us another two grand at least to get the bond on top of ponying up about four grand every three years for the accreditation. We don’t have it. We aren’t going to be supplying this stuff to Medicare/Medicaid patients anymore. In an underserved community. Thanks, CMS.
Please don’t wait till the last minute to try to get any DMEPOS items locally. Your drug store may have just been forced out of supplying them, too.