DMEPOS Changes Could Affect Patient Access
Medicare is phasing in new requirements for physicians who order or refer patients for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), and it could spell trouble for patients who rely on lifesaving DMEPOS like oxygen and nebulizers.
Beginning Jan. 4, 2010, claims will not be paid if:
- The ordering or referring physician is not on the claim
- The ordering or referring physician on the claim is not enrolled in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)
- The ordering or referring physician is not eligible to order and refer
This issue will not only affect physician suppliers of DMEPOS and independent supply companies but patients may also find it difficult to get a refill or replacement of their DMEPOS if a supplier has not been paid for a previous claim.
Visit the PECOS website to verify your PECOS enrollment or call Highmark Medicare Services provider enrollment at (866) 488-0549 if you do not have Internet access.
Get more information about the change on the Centers for Medicare and Medicaid Services website.
Last Updated: 11/6/2009