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Contract Suppliers

Please click on a question below to view the answer.


Do normal utilization parameters for accessories and supplies continue to apply when a patient transitions from a non-contract supplier to a contract supplier? For example, if a patient received a new continuous positive airway pressure (CPAP) mask in month six and transitioned to a contract supplier in month seven, is the contract supplier eligible to bill for a new mask upon setup? Can the contract supplier still provide these items, or is the patient not eligible since he or she received the mask in the month prior?

If a patient using a continuous positive airway pressure (CPAP) device switches to a contract supplier during the 90-day trial period required by the Local Coverage Determination (LCD), does the contract supplier need to get the compliance data from the original provider?

What does a contract supplier need to do in cases in which the non-contract supplier does not furnish documentation during the transition period prior to May 1, 2011, or the documentation received from the non-contract supplier is not sufficient to document adherence to Medicare guidelines?

When a beneficiary transitions from a non-contract supplier to a contract supplier, does a new order need to be obtained by the contract supplier?

When a beneficiary transitions to a contract supplier, would the contract supplier be required to have the patient repeat a facility-based sleep study?

When a patient renting capped rental DME from a non-contract supplier switches to a contract supplier, a new 13-month rental payment period begins. Does the 90-day trial period required by the Local Coverage Determination (LCD) start over as well?

What will contract suppliers be paid when they furnish oxygen and oxygen equipment or capped rental durable medical equipment (DME) to a beneficiary who transitions to them from a non-contract supplier in the middle of the 36-month or 13-month rental payment period?


last updated on 03/04/2011


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