Medicare Compliance & Reimbursement

Earliest issuances slated for Nov. 1, for lucky few.  Durable medical equipment suppliers waiting on a supplier number held up in the power wheelchair fraud-related moratorium had better be ready to wait a while longer. The absolute earliest any supplier numbers will come through will be Nov. 1, and those will be eyeballed by Centers for Medicare & Medicaid Services Administrator Tom Scully himself. If suppliers don't qualify for one of those few Nov. 1 exceptions, they can expect the normal supplier number process to resume Jan. 1, Scully said in an Oct. 7 Open Door Forum for home health and durable medical equipment. Scully's vague announcement of a "small batch" of supplier numbers being issued Nov. 1 seems much less sure than DME regional carrier Palmetto GBA's announcement last week that reactivation supplier numbers were back on. CMS is sending a strong message that "the party is over" in relation to power wheelchair and scooter fraud, Scully declared. Cleaning out bad actors is in suppliers' best interest, and putting a hold on supplier numbers while CMS scrutinizes applications as part of Operation Wheeler Dealer "is something we gotta do," Scully insisted. It will take a few months to "clean out the cobwebs and start over" with the supplier enrollment process, he added. But those couple of months could mean the difference between financial survival and disaster for some suppliers caught in the process. One supplier from Pennsylvania called in about his suspended supplier number. "I'm a new player here," he told CMS officials. Current players, not future players, have perpetrated the wheelchair fraud, but CMS is punishing the future players, he insisted. "It's putting people out of business before we start," he protested. A home medical equipment pharmacy from South Carolina also called in to report its stalled supplier number, even though it furnishes nebulizer medications and not wheelchairs or scooters. "I'll take the heat for it; I did it," Scully told the caller. "We do the best we can with the resources we have." Scully justified the hold by comparing DME fraud to the "whack-a-mole" game. Every time CMS stamps out fraud in one place, it pops up somewhere else. CMS isn't holding up just suppliers' Medicare numbers with the supplier number freeze, industry representatives said in the forum. In many states, suppliers can't obtain a Medicaid number until they acquire a Medicare number, they noted. And the freeze is jeopardizing beneficiaries' access to DMEPOS, the reps argued. But Scully dismissed any allegations of access problems. "There's not a supply and demand problem," he maintained. "We have an oversupply of people" furnishing DME, especially wheelchairs. Scully said he hadn't heard any complaints from beneficiaries regarding DME access.

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