E-CMNs are okay

Monday, March 31, 2003

In her January 2003 HME News column about audits and electronic CMNs, Jeanie Lane writes “at the present time the supplier is taking a business risk by not requiring the original CMN.”

Unfortunately, her statement about the need for a supplier to maintain a paper original in all instances is simply wrong. That is precisely why CMS issued its Sept. 27, 2002 clarification to its Sept. 2001 issuance and some DMERC statements which had been interpreted (by some) to require a supplier to maintain an original paper CMN. It is clear, from both the Sept. 27, 2002 clarification and many discussions with CMS program integrity staff, that CMS does not intend, when a supplier uses an electronic CMN, for the supplier to maintain a paper original. Instead, as the CMS Program Integrity Sept. 27, 2002 Program Memorandum states, in the event of an audit, it will be the supplier’s responsibility to prove the “validity and authenticity” of that CMN, whether that CMN is electronic, a facsimile or old-fashioned paper.

Specifically, CMS added the following language to the Program Integrity Manual in its Sept. 27, 2002 issuance:

“When a DMERC is investigating potentially fraudulent behavior by a supplier, it will be the supplier’s responsibility to prove the authenticity/validity of the claim(s) under investigation. A DMERC may require the supplier to prove the authenticity/validity of the signature on the CMN or order, or any other questionable portion of the claim(s) under investigation.

Upon request by the DMERCs, suppliers must provide the CMN, in a format that the DMERCs can accept, in a timely manner. Upon medical review, the DMERCs should not deny claims solely because the CMN is faxed, copied, or electronic. The DMERC may request the supplier to download and print a hard copy of an electronic order or CMN if the DMERC cannot access it electronically.”

Therefore, there is no CMS requirement that a supplier maintain a paper original when that supplier has used an electronic CMN.

- Cara C. Bachenheimer is an attorney with Epstein, Becker & Green in Washington
Jeanie Lane replies
Although CMS has stated that electronic CMNs are acceptable, we have to allow that there is still some risk associated with reliance on e-CMNs alone. Remember that if CMS suspects fraud and abuse, it is the supplier’s responsibility to prove the validity of their CMN. At this point, because this has been such a topic of discussion and has caused so many overpayments, we can’t ignore the risk. Obviously, there’s a difference between the kind of advice an attorney provides, and a consultant provides. I tend to err on the safe side so that my clients will not have to seek the advice of an attorney.

- Jeanie Lane is an independent consultant with The MED Group
Permobil position
I feel a need to clarify Permobil’s position in regard to certification and dealers who may do one or two of our chairs a year. In no way does Permobil, Inc. take these dealers for granted or overlook their value to the industry. It is our goal to work with all dealers and to help support and encourage certification to sell our product regardless of volume sold. I would be pleased to speak and clarify any misunderstandings anyone may have on this issue.

- Darren Jernigan is director of gov’t affairs at Permobil