In the aftermath of Hurricane Harvey and with the impending landfall of Hurricane Irma, the Centers for Medicare & Medicaid Services (CMS) would like to share some reminders and information to assist suppliers through these events.
CMS provides information and resources for Emergency Response and Recovery, including the granting of specific waivers to certain Medicare requirements under Section 1135 of the Social Security Act. For information specific to Hurricanes Harvey and Irma, including a beneficiary fact sheet, follow the link to the Hurricanes webpage.
The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Quality Standards require a contingency plan that enables suppliers to respond to emergencies and disasters or to establish arrangements with alternative suppliers in the event that the supplier cannot service its own customers as the result of an emergency or disaster. DMEPOS suppliers should review their plans to ensure they are current, all contact information is up-to-date, and discuss the plan with staff.
CMS regulations at 42 CFR §414.422(f) requires DMEPOS Competitive Bidding Program contract suppliers to notify CMS no later than 10 days after the date the supplier enters into a subcontracting arrangement. As a result of Hurricane Harvey, CMS is temporarily extending the 10 business day deadline to provide notification of any subcontracting arrangement. During the temporary extension period, affected contract suppliers will have 30 business days to provide notice of any subcontracting arrangements. CMS will notify DMEPOS Competitive Bidding contract suppliers via e-mail when this temporary extension expires. All other competitive bidding program requirements remain in force. Note: CMS will provide notice of any changes to reporting timeframes for future events. For more information on subcontracting, refer to the Subcontracting of DMEPOS fact sheet.
Replacement of DMEPOS
In all cases for which Medicare payment for replacing a DMEPOS item is available to beneficiaries residing in a competitive bidding area, the replacement item must be furnished by a contract supplier. CMS has standard policies in place to process emergency or disaster claims according to CMS regulations in the Medicare Claims Processing Manual. For specific billing information during an emergency or disaster, please see the Emergency Q&As Without an 1135 Waiver. Suppliers impacted by Hurricanes Harvey and/or Irma may also contact DME Medicare Administrative Contractor Jurisdiction C for additional information or guidance.
In certain circumstances, such as an emergency or disaster, the Competitive Bidding Implementation Contractor (CBIC) will contact contract suppliers to assess their operational status. This information is vital to determine the effects to suppliers in the region and potential impacts to Medicare beneficiaries. The CBIC utilizes its liaisons to conduct this outreach. Contract suppliers seeking additional information should call the CBIC customer service center at 877-577-5331. The CBIC customer service center is available between 9 a.m. and 5:30 p.m. prevailing Eastern Time, Monday through Friday.