CMS ups ante on enrollment standards for HME providers

Thursday, August 26, 2010

BALTIMORE - CMS filed a final rule last week on the Medicare enrollment standards for HME providers that includes some new standards and modifies some existing standards.

The final rule, according to a press release from CMS, will:

*    Require providers to obtain oxygen from a state-licensed oxygen supplier (which applies only in states that require oxygen licensure).

*    Require providers to remain open to the public for at least 30 hours per week, with exceptions for physicians or licensed non-physician practitioners furnishing services to their own patients as part of their professional services, and providers working with custom made orthotics and prosthetics.

*    Ensure that providers continue to maintain ordering and referring documentation from physicians or non-physician practitioners.

*    Prohibit providers from sharing a practice location with certain other Medicare providers subject to certain exceptions.

The final rule will also:

*    Ensure that the provider maintains a physical facility on an appropriate site that must: measure at least 200 square feet, except for state-licensed orthotic and prosthetic personnel providing custom fabricated orthotics or prosthetics in private practice; be in a location that is accessible to the public, Medicare beneficiaries, CMS, the National Supplier Clearinghouse (NSC) and its agents and not in a gated community or other area where access is restricted; be accessible and staffed during posted hours of operation; maintain a permanent visible sign in plain view and post hours of operation; and be in a location that contains space for storing business records, including the supplier's delivery, maintenance, and beneficiary communication records.

*    Prohibit the use of cell phones, beeper numbers and pagers as a primary business telephone number. In addition, answering machines and answering services may not be used exclusively as a supplier's primary telephone number during posted business hours.

*    Expand the prohibition on HME provider telephone solicitation of a Medicare beneficiary to also include in-person contacts, e-mails, instant messaging and Internet coercive advertising.

The final rule is based on a proposed rule released in January 2008.

A copy of the final rule is posted on the Federal Register site at:

The current supplier enrollment standards can be found on the NSC's website at