NSC, CMS Propose Supplier Number Standards Clarification

Columbia, S.C.

According to both government officials and industry stake-holders, vague Medicare supplier standards are partly to blame for DME fraud.

In response, earlier this year the National Supplier Clearinghouse Advisory Committee (NSCAC), which is made up of representatives from the four DMERC (durable medical equipment regional carrier) advisory councils, requested that the Centers for Medicare and Medicaid Services and the NSC draft written guidance for providers who must comply with the 21 Medicare supplier standards. At press time, the draft had been forwarded to NSCAC members, and representatives from both agencies would be “tweaking those clarifications if [committee members] have some substantive comments, which I’m sure they will,” said a CMS official.

In late April, Leslie Aronovitz, director of health care program administration and integrity issues for the General Accounting Office, testified before a Senate Finance Committee hearing on power wheelchair fraud and abuse that her agency was particularly concerned over the interpretation of several current standards, such as the inventory requirements set out in Standard No. 4.

To address the situation, the CMS official said, “We were looking at … what the problematic suppliers were using to get [into the business]. It’s not an exact science, but I think, based on the NSC’s experience, we were able to come up with something that should help guard the [Medicare] trust fund much better but not make it impossible for a legitimate supplier to get into the program.”

The agency official added that the new guidance on all 21 supplier standards will be available for public comment — posted on the NSC Web site this month — and is planned to go into effect Oct. 1.

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