Part B Insider (Multispecialty) Coding Alert

Published on Fri Feb 05, 2010 PDF

• CMS intends to clear up some murky waters with a new clarification on whether DME suppliers can contact patients.

In January, the OIG reissued a fraud alert on prohibiting unsolicited telemarketing from durable medical equipment (DME) suppliers to Medicare beneficiaries. But in the alert, the OIG said suppliers couldn't call patients even if the patients' physicians had requested that they do so.

The new twist had the supplier community up in arms, since that is the way many referrals take place. Now CMS is taking that new provision back -- at least in part. DME suppliers may contact beneficiaries if the physician contacts the supplier with the order -- AND the patient knows the physician is contacting the supplier, CMS says in a set of frequently asked questions about the telemarketing alert.

Easier: The physician doesn't even have to be specific about who will be providing the DME, CMS says. "The beneficiary need only be aware that a supplier will be contacting him/her regarding the prescribed covered item, recognizing that the appropriate supplier may not have  been identified at the time of consultation,"according to FAQ 3.

Resource: The FAQs, which also address how to handle talking to the beneficiary about other covered DME items, are online at www.cms.hhs.gov/MedicareProviderSupEnroll -- scroll down to "Downloads" and click on "DME Supplier Telemarketing Frequently Asked Questions."