Beginning July 1, 2013, must contract suppliers obtain new medical necessity documentation for continuous positive airway pressure (CPAP) or respiratory assist device (RAD) replacement accessories for beneficiaries that live in or travel to Round 2 CBAs?
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?
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?
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?
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?