Tuesday, August 31, 2004

Facing off with CMS
with Clay Stribling

Q: What effect will Medicare’s recent proposed regulations concerning DME have on my company?

A: Among other things, the regulations require that a physician or prescribing practitioner must conduct a face-to-face examination of the patient prior to providing an order for DME, and a written order must be completed and signed before delivery of any DME to the beneficiary. The regulations also provide that Medicare will not pay for face-to-face examinations conducted solely for the purpose of determining a beneficiary’s eligibility for DME. If implemented, these proposed regulations will have a significant impact on many DME companies that obtain verbal dispensing orders prior to requesting a written order from the physician. These companies will be forced to make significant changes to their current policies and procedures concerning physician orders. In addition, companies will need to review and revise their policies concerning patient intake to eliminate situations where a patient is seen by a physician solely for qualification for DME. Suppliers wishing to comment on these regulations should provide feedback to CMS no later than Sept. 24, 2004.

Clay Stribling is an attorney with Brown & Fortunato in Amarillo, Texas. He can be reached at (806) 345-6346 or