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The Centers for Medicare and Medicaid Services issued a program memorandum in May to its four durable medical equipment regional carriers calling for a “cessation of certain DMERC activities,” in particular the common DMERC practice of requiring additional documentation to support reimbursement claims submitted for power mobility equipment.

“The DMERCs that are still enforcing any [additional] documentation requirements must immediately cease that activity,” CMS stated in the memorandum.

“We are pleased the CMS has issued this memorandum,” said Steve Azia, counsel to the Washington-based Power Mobility Coalition, which has for more than a year been working with CMS on this and other issues. “It's a positive step toward clarity and consistency within the Medicare program.

“And it's not the intention of the PMC to do away with additional documentation altogether,” Azia continued. “In fact, we feel there are several instances when additional documentation is needed. We simply want to make sure that the rules set forth for providers aren't arbitrary and random, so providers know exactly what the rules are before submitting claims — instead of finding out after the fact [through a claim denial].”

The only exceptions to the rule, according to the memorandum, occur during an audit, investigation or when the DMERCs develop individual claims on either a pre- or post-payment basis. In these cases, the DMERCs still can ask for additional supporting documentation.

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