You don’t say - Q’s & A’s with CMS

Friday, April 30, 2004

WASHINGTON - On March 23, CMS officials who took part in an Open Door Forum and provided answers to the following industry questions:

Question: For DME deliveries, is it OK for a beneficiary to sign on an electronic signature pad?

Answer: Yes. The burden of proof of delivery is on the supplier, and that type of equipment should be able to reproduce a facsimile that can be printed upon request by the DMERC. “We are in the electronic age, and there is no problem in using electronic signatures,” said a CMS official.

Question: Could CMS apply competitive bidding to a DME item that may have already undergone an inherent reasonableness adjustment?

Answer: Yes. If in 2006 CMS did an IR adjustment for an item, that item could still be part of a competitive bidding program in later years. CMS can’t, however, apply IR to an item that has undergone competitive bidding.

Question: How many provider applications are now pending at the National Supplier Clearinghouse?

Answer: Of the 3,450 applications pending at the NSC at the beginning of March, about a quarter had been on hand longer than 60 days, half had been on hand fewer than 60 days and a quarter had been on hand for between 60 and 90 days.

Question: Are beneficiaries now required to meet face to face with their doctor before being prescribed a power wheelchair?

Answer: CMS checked with its general counsel who said that requirement went into effect Dec. 8 as mandated by the Medicare Modernization Act. CMS staff believe that requirement is not retroactive but are conferring with the general counsel on that point.

Question: Some state Medicaid programs claim providers cannot use the advanced beneficiary notice (ABN) upgrade on dually eligible beneficiaries. Is this the case?

Answer: From Medicare’s perspective, the dually eligible patient can use the ABN for an upgrade. Whether or not a Medicaid program allows this, is up to Medicaid. It’s not a Medicare issue.