Durable Medical Equipment, Prosthetics and Orthotics Suppliers Bond (DMEPOS)
Durable Medical Equipment Suppliers (DMEPOS) or Medicare Bond Information
A Durable Medical Equipment, Prosthetics and Orthotics Suppliers Bond (also called a DMEPOS Bond or Medicare Bond) is a federal surety bond required by the Centers for Medicare and Medicaid Services for suppliers of durable medical equipment, prosthetics, orthotics and supplies. The purpose of the bond is to help reduce the prevalence of Medicare billing fraud.
Suppliers (excluding sole proprietorships) must post a minimum $50,000 surety bond for each National Provider Identifier (NPI) practice location prior to receiving authorization to bill Medicare. A larger surety bond limit (additional coverage) is required in situations where the applicant has been subject to past legal action such as a felony conviction, loss or suspended accreditation, suspended license, or lost Medicare billing privilege.
More information can be found at the Center For Medicaid and Medicare Services (CMS) Website. Certain applicants who operate in Florida may also require the Florida Home Medical Equipment Provider Bond and/or the Florida State bond for Medicaid Providers. Business in Texas may be subject to the additional Texas Medicaid Provider Bond and businesses in Minnesota may be subject to the Minnesota DMEPOS Bond.
What Else Do I Need to Know About the DMEPOS Surety Bond?
The Centers for Medicare & Medicaid Services (CMS) has published a final rule titled, "Medicare Program: Surety Bond Requirement for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)" in the Federal Register requiring non-exempt DMEPOS suppliers to furnish and maintain a surety bond on continuing basis. Section 4312(b) requires that a surety bond be in a penal sum or coverage amount of not less than $50,000.
DMEPOS suppliers are required to purchase and submit a $50,000 surety bond for each National Provider Identifier (NPI) to the National Supplier Clearinghouse (NSC). A National Provider Identifier (NPI) must be issued for each practice location (except for sole proprietorships) so in following, a separate surety bond is required for each practice location.
Certain DMEPOS suppliers are exempt from surety bonding requirement: These include government-owned suppliers having provided CMS with a comparable surety bond under state law; state-licensed orthotic and prosthetic personnel in private practice who make custom orthotics and prosthetics but only if the business is solely-owned and operated by said personnel and is billing only for orthotic prosthetics, and supplies; physicians and non-physician practitioners if the DMEPOS items are furnished only to his or her patients as part of his or her professional service; and physical and occupational therapists if the business is solely-owned and operated by the therapist, and if the DMEPOS items are furnished only to his or her patients as part of his or her professional service.
How Do I Become an Enrolled and Accredited DMEPOS Provider?
The Centers for Medicare & Medicaid Services (CMS) uses ten national accreditation organizations to accredit suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) who meet quality standards under Medicare Part B.
Enrolling or maintaining Medicare billing privileges requires all DMEPOS non-exempt suppliers to become accredited by complying with the Medicare program's quality standards and supplier standards (42 CFR §424.57 (c)). Suppliers of durable medical equipment, medical supplies, home dialysis supplies and equipment, parenteral/enteral nutrition, transfusion medicine and prosthetic devices, therapeutic shoes, and prosthetics and orthotics all must be accredited. Exempted professionals and other suppliers are specified in the Medicare Improvement for Patients and Providers Act of 2008.
A pharmacy may be exempt from accreditation by meeting all of the following criteria: total billings by the pharmacy for DMEPOS are less than 5 percent of total pharmacy sales; the pharmacy has been enrolled as a supplier of durable medical equipment, prosthetics, orthotics and suppliers, and has been issued a provider number for at least 5 years; no final adverse action has been imposed against the pharmacy in the past 5 years; the pharmacy submits an attestation that the pharmacy meets the first three criteria; the pharmacy agrees to submit materials as requested during the course of an annual audit conducted on a random sample of pharmacies.
What Are the DMEPOS Supplier Standards?
In order to obtain and retain billing privileges, all Medicare DMEPOS suppliers must comply with Supplier Standards set forth in 42 Code of Federal Regulations (CFR), part 424, section 57. For a complete version of the DMEPOS Supplier Standards, please visit the electronic Code of Federal Regulations (e-CFR).
Who Are the Eligible Professionals for DMEPOS Accreditation?
Eligible professionals are defined in section 1848(k)(3)(B)) and include the following practitioners:
- Physicians (as defined in section 1861(r) of the Act),
- Physical Therapists,
- Occupational Therapists,
- Qualified Speech-Language Pathologists,
- Physician Assistants,
- Nurse Practitioners,
- Clinical Nurse Specialists,
- Certified Registered Nurse Anesthetists,
- Certified Nurse-Midwives,
- Clinical Social Workers,
- Clinical Psychologists,
- Registered Dietitians, and
- Nutritional professionals
MIPPA provides the Secretary with discretion to designate "other persons" that are exempt from meeting the accreditation requirements unless CMS determines that the quality standards are specifically designed to apply to such other persons. At this time, "such other persons" are limited to the following practitioners:
- Opticians, and