Slow NSC mailroom almost does in supplier

Tuesday, August 31, 2004

COLUMBIA, S.C. - July ended up being a pretty lean month for a provider who lost his Medicare supplier number because of a bureaucratic snafu.

“Here I am 27 years in business, with a spotless record with Medicare, and I get blindsided,” said the incredulous provider, who asked that his name not be used for this story. “What a horror story.”

It all started this spring. That’s when the provider decided not to renew his HME license in a neighboring state because a contract he serviced there ended. The pharmacy board in that state administers the HME licensing program. When the provider failed to renew his license, the board notified, among other agencies, the NSC. Sixty days later in mid June, the provider received a letter from the NSC saying he had run afoul of Supplier Standard #1, which states: “A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.”

The NSC gave the provider 15 days, as is customary in cases of suspected non compliance, to prove his good standing or have his Medicare supplier number revoked.

The provider’s attorney immediately crafted a letter explaining the situation: His client no longer provided services in the neighboring state and therefore didn’t need an HME license there. On July 4, the NSC deactivated the provider’s supplier number.

“We responded well within the 15 day period ,” the provider said. “I could not have responded quicker. Their mail room is so slow that you couldn’t hit the 15 days if you hand walked it to them.”

When it comes to official correspondence such as a request for reconsideration or a rebuttal, the NSC requires it be sent via mail or overnight courier. Faxes are not accepted. Consequently, the 15 day window to prove compliance is not always sufficient, say sources.

(For the NSC’s take on its mailroom activities, see the Q&A with NSC Director Nancy Parker.)

Fortunately for this provider, the NSC fraud analyst handling the case resolved the issue as soon as she received the paperwork, said the provider’s attorney, Clay Stribling. The NSC reinstated the provider’s supplier number July 20, and will reimburse all the money he is owed.

“They acted very quickly to undo something that they realized was the result of some bad information from a state agency,” said Stribling, a healthcare attorney at Brown & Fortunato in Amarillo, Texas.