If a contract supplier is involved in a change of ownership (CHOW) with a supplier that chose to become a grandfathered supplier, can the contract supplier continue to serve those grandfathered beneficiaries after the CHOW transaction is effective? If yes, will CMS make additional payments for the grandfathered items?
Yes, the contract supplier may continue to serve these beneficiaries throughout the remainder of the rental period. By purchasing a grandfathered supplier, the contract supplier is essentially stepping into the shoes of the grandfathered supplier. For that reason, no additional payments will be authorized.
Examples of what contract suppliers will be paid as a grandfathered supplier:
- For rented items in the oxygen product category, the contract supplier will be paid the single payment amount for the remainder of the existing rental period or until the item is no longer medically necessary.
- For rented items in the capped rental product categories (hospital beds; continuous positive airway pressure (CPAP) devices; respiratory assistive devices (RADs); standard (manual and power) wheelchairs and scooters; support surfaces and negative pressure wound therapy (NPWT) pumps, the contract supplier will be paid the fee schedule amount for the remainder of the existing rental period or until the item is no longer medically necessary.
- For rented items in the inexpensive or routinely purchased (IRP) product category (walkers), the contract supplier will be paid the fee schedule amount until the point at which payments for the item equal 100 percent of the fee schedule amount for the purchase of the item.