Home Health & Hospice Week

Suppliers should direct NCD-related payment woes to regional offices.

The Centers for Medicare & Medicaid Services has thrown out the old bed- or chair-confined standard for wheelchairs - and the agency wants to know if contractors try to bring it back.

The national coverage determination for mobility assistive equipment became final the moment it was posted to the agency's Web site, which means the functional ambulation standard is now the law of the land, a CMS spokesperson tells Eli.

As a result, durable medical equipment suppliers should not have their claims denied simply because beneficiaries are not completely restricted to beds or chairs. If that does happen, the agency wants suppliers to blow the whistle, it recently made clear.

"If someone is having trouble getting their DMERC to pay the claim, the first remedy is to contact the CMS regional office," the CMS spokesperson says.

The supervising regional office for HealthNow is New York, for CIGNA Government Services and Palmetto GBA is Atlanta, and for AdminaStar Federal is Chicago.

Some suppliers report that the DMERCs have said they will apply the bed- or chair-confined standard until they get further instruction from CMS.

Editor's Note: For CMS regional office contact information, visit www.cms.hhs.gov/about/regions/professionals.asp.