RIGHTS-REPSONSIBILITIES-STANDARDS

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MEDICARE SUPPLIER STANDARDS:
1. A supplier must be in compliance with all applicable Federal and State
licensure and regulatory requirements.
2. A supplier must provide complete and accurate information on the
DMEPOS supplier application. Any changes to this information must be
reported to the National Supplier Clearinghouse within 30 days.
3. An authorized individual (one whose signature is binding) must sign the
application for billing privileges.
4. A supplier must fill orders from its own inventory, or must contract with
other companies for the purchase of items necessary to fill the order. A
supplier may not contract with any entity that is currently excluded from
the Medicare program, any State health care programs, or from any
other Federal procurement or non-procurement programs.
5. A supplier must advise beneficiaries that they may rent or purchase
inexpensive or routinely purchased durable medical equipment, and of
the purchase option for capped rental equipment.
6. A supplier must notify beneficiaries of warranty coverage and honor all
warranties under applicable State law, and repair or replace free of
charge Medicare covered items that are under warranty.
7. A supplier must maintain a physical facility on an appropriate site.
8. A supplier must permit CMS, or its agents to conduct on-site
inspections to ascertain the supplier’s compliance with these standards.
The supplier location must be accessible to beneficiaries during
reasonable business hours, and must maintain a visible sign and posted
hours of operation.
9. A supplier must maintain a primary business telephone listed under the
name of the business in a local directory or a toll-free number available
through directory assistance. The exclusive use of a beeper, answering
machine or cell phone is prohibited.
10. A supplier must have comprehensive liability insurance in the amount
of at least $300,000 that covers both the supplier’s place of business and
all customers and employees of the supplier. If the supplier
manufactures its own items, this insurance must also cover product
liability and completed operations.
11. A supplier must agree not to initiate telephone contact with
beneficiaries, with a few exceptions allowed. This standard prohibits
suppliers from calling beneficiaries in order to solicit new business.
12. A supplier is responsible for delivery and must instruct beneficiaries on
use of Medicare covered items, and maintain proof of delivery.
13. A supplier must answer questions and respond to complaints of
beneficiaries, and maintain documentation of such contacts.
14. A supplier must maintain and replace at no charge or repair directly, or
through a service contract with another company, Medicare-covered
items it has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than full quality for
the particular item) or unsuitable items (inappropriate for the beneficiary
at the time it was fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these supplier standards to each beneficiary to
whom it supplies a Medicare-covered item.
17. A supplier must disclose to the government any person having
ownership, financial, or control interest in the supplier.
18. A supplier must not convey or reassign a supplier number; i.e., the
supplier may not sell or allow another entity to use its Medicare billing
number.
19. A supplier must have a complaint resolution protocol established to
address beneficiary complaints that relate to these standards. A record of
these complaints must be maintained at the physical facility.
20. Complaint records must include: the name, address, telephone number
and health insurance claim number of the beneficiary, a summary of the
complaint, and any actions taken to resolve it.
21. A supplier must agree to furnish CMS any information required by the
Medicare statute and implementing regulations.
22. All suppliers must be accredited by a CMS-approved accreditation
organization in order to receive and retain a supplier billing number.
The accreditation must indicate the specific products and services, for
which the supplier is accredited in order for the supplier to receive
payment of those specific products and services (except for certain
exempt pharmaceuticals).
23. All suppliers must notify their accreditation organization when a new
DMEPOS location is opened.
24. All supplier locations, whether owned or subcontracted, must meet the
DMEPOS quality standards and be separately accredited in order to bill
Medicare.
25. All suppliers must disclose upon enrollment all products and services,
including the addition of new product lines for which they are seeking
accreditation.
26. Must meet the surety bond requirements specified in 42 C.F.R.
424.57(c).
PATIENT RIGHTS AND RESPONSIBILITIES
Patient Rights:
1. The patient has the right to considerate and respectful service.
2. The patient has the right to obtain service without regard to
race, creed, national origin, sex, age, disability, diagnosis or
religious affiliation.
3. Subject to applicable law, the patient has the right to
confidentiality of all information pertaining to his/her
medical equipment service. Individuals or organizations not
involved in the patient’s care may not have access to the
information without the patient’s written consent.
4. The patient has the right to make informed decisions about
his/her care.
5. The patient has the right to reasonable continuity of care and
service.
6. The patient has the right to voice grievances without fear of
termination of service or other reprisal in the service process.
Patient Responsibilities:
1. The patient should promptly notify the Home Medical
Equipment Company of any equipment failure or damage.
2. The patient is responsible for any equipment that is lost or
stolen while in their possession and should promptly notify
Home Medical Equipment Company in such instances.
3. The patient should promptly notify the Home Medical
Equipment Company of any changes to their address or
telephone.
4. The patient should promptly notify the Home Medical
Equipment Company of any changes concerning their
physician.
5. The patient should notify the Home Medical Equipment
Company of discontinuance of use.
6. Except where contrary to federal or state law, the patient is
responsible for any equipment rental and sale charges which the
patient’s insurance company/companies does not pay.