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CMS DME Rule Enforcement Delay

 

A message from the American Nurses Association, January 10, 2014

Most recently, it has come to our attention that some nurse practitioners have been experiencing difficulty ordering DME items. We understand that some companies are implementing the rule even though an enforcement date has not been released. The American Nurses Association (ANA) has reached out to CMS to address this issue but could use your assistance in identifying where this is taking place and informing your Members of Congress about the negative impact on patient care. In the meantime show the supplier the announcement from CMS (listed below) and urge them to fill the order.

As CMS states in their announcement on December 3, 2013, the rule is in effect, but ENFORCEMENT has been delayed until an UNSPECIFIED DATE IN 2014.

Below is a quote from the CMS announcement.

"Although many durable medical equipment suppliers and physicians are aware of and are currently complying with this policy, CMS is concerned that some may need additional time to establish operational protocols necessary to comply with this new law. As such, CMS expects that during the next several months, suppliers and physicians who order certain DME items will continue to collaborate and establish internal processes to ensure compliance with the face-to-face requirement. CMS expects all durable medical equipment suppliers to have fully established such internal processes and have appropriate documentation of required encounters by a date that will be announced in Calendar Year 2014. Those suppliers and physicians who are currently implementing the face-to-face requirement should continue to do so. "

ANA's President Karen Daley has asked CMS for permanent delay, or a change in the list of items that CMS developed that requires the redundant physician sign-off on the APRN order. But short of a legislative fix, which ANA and the APRN Community are investigating, there aren't many other options.

Reaching out to your Senators or Representative's office to ask them to contact CMS on your behalf is a great idea. Additionally as suggested above, show the supplier the announcement from CMS and urge them to fill the order.

ANA continues to monitor and advocate on this issue and we will keep you posted on any further developments.

Please do not hesitate to contact April Canter at april.canter@ana.org or Andrea Brassard at andrea.brassard@ana.org if you have any questions or if you require further assistance.

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