GDA Action September 2019

16 • September 2019 Surety Bonds Required for Dentists who are Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Suppliers Are you a Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) provider that has enrolled using CMS Form 855S? If so, the U.S. Centers for Medicare & Medicaid Services (CMS) surety bond requirement applies to you. There are only about 1,800 dentists currently enrolled as DMEPOS providers. Key Points • CMS is requiring all dentists who are DMEPOS suppliers to obtain a $50,000 surety bond per office location. • Letters from CMS were mailed to DMEPOS providers, including dentists, the week of June 3. The letter explains the reasoning CMS used to arrive at this requirement. • All dentists who are enrolled in Medicare as DMEPOS suppliers will have to comply within 90 calendar days of receipt of notification from CMS. • ADA has contacted CMS to voice our concerns and opposition to this requirement. However, CMS has not changed its decision. • Please note that this will not affect most dentists. It will only affect dentists who have enrolled as DMEPOS suppliers. An oral sleep apnea appliance for Medicare beneficiaries is an example of a Medicare DMEPOS covered device. • Dentists who believe they are entitled to the exception may provide documentation to CMS that they are prescribing the DMEPOS items they are supplying to Medicare beneficiaries as part of their “physician service,” and subject to other Medicare requirements regarding prescribing and filling DMEPOS. However, it is important to note that: »» CMS has taken the position that the surety bond exception only extends to physicians who are both prescribing and filling the product in the course of their own “physician service.” »» Medicare will not reimburse a dentist for supplying an oral sleep apnea device to a Medicare beneficiary unless the requirements of Local Coverage Determination (LCD) 33611 are met. »» LCD 33611 includes several criteria, including a criterion that the device is prescribed by a “physician.” CMS has taken the position that in this context the term physician does not include a dentist. »» An address to which all applicable documentation should be sent will be provided in the letter from CMS. »» The documentation would need to clearly indicate that the dentist is prescribing DMEPOS in accordance with Medicare coverage determinations. For questions concerning the CMS notice, you may contact the National Supplier Clearinghouse (NSC) at 803.735.1034 or the ADA Third Party Payer Concierge at 800.621.8099. SEEN& HEARD