- Dme Mac Jurisdiction D Supplier Manual
- Dme Mac Jurisdiction D Supplier Manual
- Jurisdiction D Dme Mac Supplier Manual User
- DME MAC or ZPIC medical staff must resolve the issue. Acceptability of Faxed Orders and Facsimile or Electronic CMNs or DIFs CMS Manual System, Pub. 100-08, Medicare Program Integrity Manual, Chapter 5, §5.3 When reviewing claims and orders or auditing CMNs or DIFs for DMEPOS, DME MACs and ZPICs.
- To support our suppliers, a COVID-19 Hotline has been established to help with COVID-19 related inquiries. The hotline number is: 866-575-4067. Customer services representatives will be available Monday-Friday from 8 a.m.-6 p.m.
DME MACs (A55426) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR NAME CONTRACT TYPE CONTRACT NUMBER JURISDICTION STATE(S) CGS Administrators, LLC DME MAC 17013 - DME MAC J-B Illinois Indiana Kentucky Michigan Minnesota Ohio Wisconsin.
Change of Ownership-Guidelines and Responsibilities
A DMEPOS supplier participating in the competitive bidding program that is negotiating a change of ownership (CHOW) must notify CMS 60 days before the anticipated date of the change. This fact sheet explains how to notify CMS, the process for transferring a contract, and the requirements to effectuate the transfer.
Common Ownership and Common Control
Suppliers are prohibited from competing against themselves when submitting bids in the DMEPOS Competitive Bidding Program. Therefore, suppliers that are commonly owned or commonly controlled must submit one bid for the same product category in the same CBA.
Enteral Nutrition
With the exception of skilled nursing facilities (SNFs) and nursing facilities (NFs) that become specialty suppliers, suppliers that are contract suppliers for the enteral nutrition product category must furnish services to beneficiaries throughout the competitive bidding area, regardless of whether a beneficiary lives in a private residence or institutional setting.
Exemptions from the Requirement to Be a Contract Supplier for Competitively Bid Items and Services
Non-contract suppliers that furnish competitively bid items in a CBA are not eligible for Medicare Part B payment for the competitively bid items for that CBA unless one or more exceptions apply.
Grandfathering for Oxygen and Oxygen Equipment
Suppliers that are not awarded a competitive bidding contract for furnishing oxygen and oxygen equipment in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Grandfathering for Rented DME
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Dme Mac Jurisdiction D Supplier Manual
Hospitals That Are Not Contract Suppliers
This fact sheet discusses an exception, which allows hospitals to furnish competitively bid walkers in a competitive bidding area to their own patients without being a contract supplier.
Physicians and Other Treating Practitioners Who are Enrolled as Medicare DMEPOS Suppliers
Physicians and other treating practitioners who are enrolled as Medicare DMEPOS suppliers may furnish certain competitively bid items in a CBA to their own patients without submitting a bid and being selected as a contract supplier, if specific requirements are met.
Prescription for Specific Brand or Mode of Delivery to Avoid an Adverse Medical Outcome
The Medicare DMEPOS Competitive Bidding Program includes a special beneficiary safeguard to ensure that beneficiaries have access to specific brands or modes of delivery of competitively bid items when needed to avoid an adverse medical outcome.
Repairs and Replacements
This fact sheet contains important information about repairs and replacements of beneficiary-owned equipment under the DMEPOS Competitive Bidding Program.
Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs)
Skilled nursing facilities (SNFs) and nursing facilities (NFs) are subject to the Medicare DMEPOS Competitive Bidding Program to the extent that competitively bid items and services are furnished to their own residents under Medicare Part B.
Subcontracting of DMEPOS Services
The primary supplier is responsible for the overall service of furnishing the item and coordinating the care for the beneficiary in compliance with the physician's order and Medicare rules and guidelines, but the primary supplier may subcontract certain services.
Supplier Marketing Guidelines
All of the existing rules and regulations regarding marketing DMEPOS to beneficiaries under the fee-for-service program also apply to DMEPOS contract suppliers under competitive bidding.
Tips for Serving Qualified Medicare Beneficiaries
When serving dually eligible beneficiaries in your area, it is important to understand the special protections for the 7 million who are 'Qualified Medicare Beneficiaries.'
DME MACs (A55426) Links in PDF documents are not guaranteed to work. To follow a web link, please use the MCD Website. Contractor Information CONTRACTOR NAME CONTRACT TYPE CONTRACT NUMBER JURISDICTION STATE(S) CGS Administrators, LLC DME MAC 17013 - DME MAC J-B Illinois Indiana Kentucky Michigan Minnesota Ohio Wisconsin.
Change of Ownership-Guidelines and Responsibilities
A DMEPOS supplier participating in the competitive bidding program that is negotiating a change of ownership (CHOW) must notify CMS 60 days before the anticipated date of the change. This fact sheet explains how to notify CMS, the process for transferring a contract, and the requirements to effectuate the transfer.
Common Ownership and Common Control
Suppliers are prohibited from competing against themselves when submitting bids in the DMEPOS Competitive Bidding Program. Therefore, suppliers that are commonly owned or commonly controlled must submit one bid for the same product category in the same CBA.
Enteral Nutrition
With the exception of skilled nursing facilities (SNFs) and nursing facilities (NFs) that become specialty suppliers, suppliers that are contract suppliers for the enteral nutrition product category must furnish services to beneficiaries throughout the competitive bidding area, regardless of whether a beneficiary lives in a private residence or institutional setting.
Exemptions from the Requirement to Be a Contract Supplier for Competitively Bid Items and Services
Non-contract suppliers that furnish competitively bid items in a CBA are not eligible for Medicare Part B payment for the competitively bid items for that CBA unless one or more exceptions apply.
Grandfathering for Oxygen and Oxygen Equipment
Suppliers that are not awarded a competitive bidding contract for furnishing oxygen and oxygen equipment in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Grandfathering for Rented DME
Suppliers that are not awarded a competitive bidding contract for furnishing rented DME in a CBA can decide to be grandfathered suppliers for beneficiaries to whom they are furnishing these items at the time the competitive bidding program is implemented.
Dme Mac Jurisdiction D Supplier Manual
Hospitals That Are Not Contract Suppliers
This fact sheet discusses an exception, which allows hospitals to furnish competitively bid walkers in a competitive bidding area to their own patients without being a contract supplier.
Physicians and Other Treating Practitioners Who are Enrolled as Medicare DMEPOS Suppliers
Physicians and other treating practitioners who are enrolled as Medicare DMEPOS suppliers may furnish certain competitively bid items in a CBA to their own patients without submitting a bid and being selected as a contract supplier, if specific requirements are met.
Prescription for Specific Brand or Mode of Delivery to Avoid an Adverse Medical Outcome
The Medicare DMEPOS Competitive Bidding Program includes a special beneficiary safeguard to ensure that beneficiaries have access to specific brands or modes of delivery of competitively bid items when needed to avoid an adverse medical outcome.
Repairs and Replacements
This fact sheet contains important information about repairs and replacements of beneficiary-owned equipment under the DMEPOS Competitive Bidding Program.
Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs)
Skilled nursing facilities (SNFs) and nursing facilities (NFs) are subject to the Medicare DMEPOS Competitive Bidding Program to the extent that competitively bid items and services are furnished to their own residents under Medicare Part B.
Subcontracting of DMEPOS Services
The primary supplier is responsible for the overall service of furnishing the item and coordinating the care for the beneficiary in compliance with the physician's order and Medicare rules and guidelines, but the primary supplier may subcontract certain services.
Supplier Marketing Guidelines
All of the existing rules and regulations regarding marketing DMEPOS to beneficiaries under the fee-for-service program also apply to DMEPOS contract suppliers under competitive bidding.
Tips for Serving Qualified Medicare Beneficiaries
When serving dually eligible beneficiaries in your area, it is important to understand the special protections for the 7 million who are 'Qualified Medicare Beneficiaries.'
Dme Mac Jurisdiction D Supplier Manual
Transitioning Beneficiaries
This fact sheet contains guidance about a supplier's responsibilities when a beneficiary transitions from a current supplier to a new supplier.
Jurisdiction D Dme Mac Supplier Manual User
Traveling Beneficiary
DMEPOS suppliers that provide items to Medicare beneficiaries who reside in or travel to competitive bidding areas must follow specific guidelines. This fact sheet includes information on how to determine whether a beneficiary is in a traveling status, how to properly bill Medicare for the item, and how Medicare will determine the payment amount.
