Updates from Quarterly Call with the NSC and CBIC

NSC updates:

  1.  A new 855S application is available on the CMS website at www.cms.gov .  The new version is effective immediately.

                Changes on the new 855S:

A.      Need to list States that the Supplier does business in for that location.  If a Supplier ships to other States on a regular basis, then they need to list those States and be properly licensed according to the State requirements.

B.      If medical records are stored electronically, the Supplier needs to indicate where and how the records are stored, i.e.  on company software, in the cloud.  They are not trying to get access to medical records; they just need to know the process.

C.      The 2013 application fee is $532.

  1. CMS extended open enrollment to February 15, 2013
  2. NSC Robo Calls: the NSC is now using an automated Robo-call system to contact Suppliers to let them know if they are awaiting additional information for development. The automated system has been in place since the end of November with some success.  This process was started in lieu of an NSC CSR making the call.  If an application has been developed and there is no response by day 30, then it’s closed out. 
  3. Clarification on Licensure in multiple States:   If a Supplier regularly does business in a group of States (Ships products) then they need to list all of those States on their application and be properly licensed in those States.  However if the Supplier has a patient traveling out of State, and the Supplier is not licensed there, and the patient needs a product shipped to them, it is ok to do so and bill Medicare as long as it is not on a regular basis;  make sure the situation is well documented.  For capped rental oxygen patients that travel, if the home Supplier subcontracts with another Licensed Supplier in that State to provide service then the home Supplier can bill Medicare and it will be acceptable.  However, be sure the arrangements with the Licensed Supplier are well documented in the patient’s chart. 

The Supplier needs to be licensed in the State (or States) where business is performed on a regular, ongoing basis.  In the event an inspector wants to see the Suppliers out of State license for items billed to patients in another State, then the Supplier needs to have the proper license or the complete documentation as to why those items were billed.


CBIC Updates:

  1. Single payment amounts will be released by CMS in Early 2013.
  2. Announcement of contracted Suppliers will start in Spring 2013.
  3. Round 2 Implementation is still schedule for July 1, 2013.
  4. 19 additional Liaisons have been hired to provide education to all Stakeholders from April 1, 2013 to June 30, 2013.