Bill Popomaronis, R.Ph., NCPA vice president, home health and long term care pharmacy services, provides his thoughts and explanations on the latest DME information from CMS.




Monday, July 9, 2007

CMS Controls Will Deter Diabetic Supply Billing Fraud

Last week, the Competitive Bidding Implementation Contractor (CBIC) website was updated with several Q&As regarding mail order diabetic supplies. In addition, most Q&As relating to the mail order competitive bidding program were reorganized under a separate "Mail Order" page under the "FAQ" section of the CBIC website.

The web address is: http://www.dmecompetitivebid.com/cbic/cbic.nsf/
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Medicare payment will NOT be made to non-contract suppliers that furnish mail order diabetic testing supplies to Medicare beneficiaries residing in a CBA. A special modifier will be used on each claim to indicate that the item was furnished on a mail order basis. Suppliers who furnish diabetic testing supplies on a mail order basis and do not attach the mail order modifier could be subject to significant penalties.