CMS Gives Providers, Patients Hit by Hurricane Harvey a Much-Needed Break

CMS releases guidance that it will replace lost, damaged and destroyed DME in areas affected by the disaster.

As Hurricane Irma tears its way across the Caribbean towards Florida, CMS has released guidance stating that it will replace DME that was lost or damaged during Hurricane Harvey

In a public statement available at http://go.cms.gov/2gNlzT5, CMS said that for affected patients in Texas and Louisiana, “When durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) are lost, destroyed, irreparably damaged, or otherwise rendered unusable due to circumstances relating to a declared emergency, Medicare will pay for the replacement DMEPOS that a Medicare beneficiary owns or purchased.”

Furthermore, HHS Secretary Tom Price has established a blanket waiver under section 1135 of the Social Security Act that states that usually mandatory face-to-face, physician’s order, and medical necessity documentation are not required for the replacement items. That said, providers must include a narrative description on the claim explaining the reason why the equipment must be replaced. They must also maintain documentation indicating that the previous DME items was lost, destroyed, or irreparably damaged.

Additional points in CMS’s guidelines:

  • The replacement item must be furnished by a Medicare-enrolled supplier
  • If the beneficiary needs a piece of DME that falls under competitive bidding and they are in a competitive bidding area, they must use a contract supplier.
  • Providers with bid contracts may continue to subcontract with Medicare-enrolled providers without contracts per existing program regulations.
  • CMS is temporarily extending the 10 business day
  • The deadline to provide notification regarding any subcontracting arrangement has been extended from 10 days to 30 days.

Providers with competitive bidding contracts that requiring assistance should call the Competitive Bidding Implementation Contractor (CBIC) customer service center at (877) 577-5331. 


About the Author

David Kopf is the Editor of HME Business.

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