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Guides > Medicare DMEPOS Enrollment and Bonding Guide

Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) include any medical equipment that gives therapeutic benefits to patients with a particular medical illness and/or need.

In order to become a registered supplier of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), you must submit an application and supporting documents (such as a surety bond) to the Centers for Medicare & Medicaid Services (CMS).

This guide will explain who needs to go through this process in order to supply DMEPOS equipment, how to apply, and how to get the required surety bond.

 

medicare DMEPOS enrollment and bonding guide

 

Supplier Standards

In November 2006, CMS approved 10 national accreditation organizations that accredit suppliers of DMEPOS. The new approval means the 10 accredited organizations meet new and strict policy standards under Medicare part B.

In order for suppliers to enroll or to keep Medicare billing privileges, every DMEPOS supplier must now abide by the Medicare program’s supplier standards. Equipment includes therapeutic shoes, durable medical equipment, medical supplies, transfusion medicine, prosthetics and orthotics, parenteral/enteral nutrition, home dialysis supplies and equipment, and prosthetic devices.
National Provider Identification

Each location that a supplier manages requires a National Provider Identification. This is a 10-digit identification number unique to each health care provider in the United States issued by the Centers for Medicare & Medicaid Services. A NPI can be assigned by the CMS within 10 days of application only if the application is free of errors.

 

DMEPOS Equipment Guidelines

Medical Equipment falls under the DMEPOS category if it meets these requirements:

  1. Mostly used to serve a medical purpose
  2. Not useful in the absence of an illness or injury
  3. Ordered or prescribed by a physician
  4. Can be reused and used repeatedly
  5. Have the ability to be used in the home

More specifically, medical equipment includes but is not limited to: wheelchairs, hospital beds, monitors, oxygen, lifts, nebulizers, kidney machines, canes, crutches, walkers, etc. A client that receives medical supplies such as these from a registered supplier will be covered for durable medical equipment, equipment maintenance and repairs, replacements of equipment, as well as rental equipment instead of having to purchase it new.

 

Exempt Professionals

However, there are certain medical professionals who are exempt from these accreditation standards. On March 23, 2010, HR 3590 was signed into Public Law no: 111-148, amending Title XVII of Social Security Act. Now, a pharmacy is exempt from accreditation standards if the pharmacy meets all of the following criteria.

  • Total DMEPOS billings for the pharmacy is less than 5% of all pharmacy sales
  • The pharmacy has been enrolled as a DMEPOS supplier and has had a provider number for the past 5 years
  • No unfavorable action has been taken against the pharmacy for the past 5 years
  • The pharmacy submits an attestation to the CMS, and is determined by the CMS that the pharmacy meets the first 3 criteria listed above
  • During the course of a random audit, the pharmacy agrees to submit requested materials

 

DMEPOS Enrollment Application

An application to enroll as a Medicare Supplier can be found on the CMS website. The application can be filled out electronically and then submitted by hard copy since a handwritten signature is required. Fortunately, filling out the application online provides fewer chances for mistakes, questions, and delays when the application is processed. It is a good idea to keep a copy of the signed application for personal records.

After the application is filled out, it must be signed by the applicant before it is mailed. If this step is not completed, the application will not be reviewed. The completed and signed application along with any supporting documents must then be mailed to the particular Medicare-fee-for-service contractor. Additional forms including the CMS-588 and CMS-460 forms can be found on the CMS website.

Application Cost

The application fee is $560 which allows the Secretary of State to cover the cost of screening for the application. This fee is for 2017, and will vary from year to year. Applications that are not paid for will not be processed.

 

DMEPOS Supplier Surety Bond

This type of surety bond can be referred to by different titles including Medicare Surety Bond, DMEPOS Surety Bond, Medicaid Surety Bond, Medicaid DMEPOS, or Medicare DMEPOS.

The Centers for Medicare and Medicaid Services (CMS) requires a surety bond in order to control and to stop medical billing fraud. This bonding requirement was established in 2009 when medical billing fraud became an issue in the healthcare industry.

A DMEPOS supplier must file a $50,000 surety bond in order to bill Medicare. Also, if there is a change of ownership within the business, a surety bond must be obtained in order to move to a new business location.

Since these bonds are required by the CMS, the bonds are referred to as both a Medicare Surety Bond and a Medicaid Surety Bond. These provider bonds are alike, although they are not issued in the same form.

A Medicare or Medicaid surety bond protects clients from fraud or malpractice by bonded DMEPOS physicians or medical professionals. The bond guarantees all claims filed to Medicare are legal and legitimate. CMS is financially assured by this bond that any potential claims will be resolved by the surety company. If there is a legitimate claim filed against the bond, the surety company will reimburse the client who filed the claim. The bonded supplier or provider would then be responsible to pay the surety company back for the claim.

Surety Bond Cost

Just like any other surety bond, there are many factors that influence the cost of a Medicare bond. The bond amount, the credit score of the applicant, the surety company that ensures the bond, and the type of bond factor into the bond cost (also known as the bond premium).

For each location the DMEPOS supplier manages, a National Provider Identifier (NPI) must be covered with a $50,000 surety bond. For example, if a DMEPOS supplier manages 2 NPI locations, the supplier would need a $100,000 surety bond. Each DMEPOS location needs to be bonded.

 

Apply for Your Bond

Aiming to promote success for clients, Surety1 works to achieve the lowest possible price for bonds. Visit the application page to apply for a DMEPOS surety bond. For any questions, our friendly agents will be happy to assist the client in any way. It is free to apply and payments can either be made online or over the phone.

1. Complete an online application.
2. One of our surety experts will call and email you with the firm quote and an agreement to sign.
3. Provide payment and your signed agreement, then you will receive your bond!

 

Get More Help

Call us toll free at 877-654-2327. We have live surety bond agents available Monday – Friday, 8:00 – 4:30 PST. We’re glad to help!