Updated documentation requirements are now in effect for refillable types of DMEPOS purchased by Medicare, the Centers for Medicare & Medicaid Services (CMS) said in a new bulletin.
The U.S. Department of Health & Human Services released the bulletin on Feb. 14. A related MLN Matters article noted that the implementation date for the new requirements was Feb. 19.
Confirm that DMEPOS refills are needed
The new requirements affect DMEPOS that is continually used and needs to be regularly resupplied.
“In some cases, a practitioner may determine a patient’s expected, ongoing medical need, and write an order for DMEPOS for immediate use and refills for later dates,” the MLN Matters article said. “Before refilling orders for DMEPOS products, suppliers must contact the patient to make sure a refill is needed. Don’t automatically ship a refill on a pre-determined basis, even if the patient authorizes it. The supplier must document contact with the patient or their representative and verify the need for the refill.”
Under the new policy, documentation must include “evidence that the patient or their representative has confirmed their need to refill the supplies within 30 calendar days from the expected end of the current supply.”
The refilled supply can’t be delivered “sooner than 10 calendar days before the end of usage for the current product.”
But consumers are not required to count and report their remaining DMEPOS supply.
If a Medicare beneficiary gets the refill by visiting a DMEPOS retail location, CMS said acceptable documentation includes a delivery slip signed by the beneficiary or the beneficiary’s representative, or a copy of an itemized sales receipt.
Documentation requirements for shipped refills
Before a supplier ships a DMEPOS refill to a beneficiary, CMS requires the supplier to document the patient’s name, date of contact, item requested, confirmation from the patient, and an explanation for the refill.
“You may use any means of communication to contact the patient to get their confirmation for the refill of the supplies, but you must include it in the documentation,” the bulletin said. “For example, you can use automated text messaging or email showing the patient’s name, items, date of contact, and their response. The documentation must be available to us upon request.”
