At presstime for this issue, Republicans were lining up for a run at repeal of the Patient Protection and Affordable Care Act (PPACA), which was signed into law on March 23, 2010. Here's a refresher on some provisions in the health reform law with serious effects for DME suppliers.
Power Wheelchairs: The purchase option is available only to complex rehabilitation power wheelchairs and not to other power wheelchairs. Additionally, the rental payment amounts change to 15 percent for the first three months and 6 percent for the remaining rental months.
Provider Screening and Enrollment: Providers and suppliers enrolling or re-enrolling in Medicare, Medicaid or CHIP will be subject to screening measures established by the HHS Secretary. All providers and suppliers will be subject to licensure checks and, if the Secretary determines, additional screening measures such as criminal background checks, fingerprinting and unscheduled and unannounced site visits.
Applicants will also be required to disclose any current or previous affiliations with any provider or supplier that has uncollected debt, been subject to payment suspension under a federal health care program, excluded from a federal health care program or has had billing privileges denied or revoked. The Secretary may deny enrollment if such affiliations pose an undue risk of fraud, waste or abuse.
In determining the size of a surety bond, the Secretary must take into account the volume of billing for a DME supplier. As well, the Secretary may impose a temporary moratorium on the enrollment of new providers and suppliers if it is determined such action is necessary to prevent or combat fraud, waste or abuse.
The Secretary may adjust payments to a provider or supplier that has the same tax ID number as a provider or supplier that owes past-due obligations under Medicare, Medicaid or CHIP, regardless of such provider's or supplier's Medicare billing number or NPI.