Grandfathering decision deadline approaching

WASHINGTON, D.C., April 10, 2013—In grandfathering documents posted here (www.dmecompetitivebid.com), the Centers for Medicare & Medicaid Services (CMS) states: “Non-contract suppliers must provide written notification of their decision whether to be a grandfathered supplier to all of their Medicare beneficiaries who reside in a competitive bidding area (CBA) and are currently renting competitively bid DME or oxygen and oxygen equipment at least 30 business days prior to program implementation.”  This means that suppliers must send notifications to their patients not later than May 20, 2013, to meet the 30 “business” days requirement.

The notification process also states that non-contract suppliers who choose not to grandfather must maintain proof of delivery of the written notices, but does not indicate in what form this proof must be. In all cases this will add to the cost of the notification process. Suppliers should consider using their AAHomecare membership benefits to receive a discount from FedEx.

The CMS grandfathering documents also state that suppliers are required to make two additional notices, one 10 days and another two days before pick-up of their equipment. The transfer of the rental to the new supplier must be the first anniversary date of the rental occurring after July 1, 2013.

The same rules also apply to suppliers who choose to grandfather. However, in this case the beneficiary has the option to choose a contract supplier or stay with their current non-contract supplier. The beneficiary may provide their decision verbally or in person, and does not have to sign any document to that effect; however the supplier must document the beneficiary’s decision including the date and how their choice was communicated.

Two very important points for non-contract suppliers to remember are:
• Non-contract suppliers are not required to find a contract supplier for a patient, but rather must refer the beneficiary to the supplier directory at www.medicare.gov and/or provide the 800-Medicare phone number.
• Grandfathering provisions also apply to patients who transfer to Medicare Advantage Plans. Click here for sample beneficiary letters for suppliers choosing to grandfather.