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Frequently Asked Questions |
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- Diabetes testing supplies are exempt from CMS accreditation requirements RIGHT?
- False – Pharmacists selling diabetes testing supplies MUST obtain facility accreditation.
- The Medicare Improvements for Patients and Providers Act (MIPPA) of 2008 exempts pharmacists from meeting DMEPOS accreditation requirements?
- False - MIPPA delayed competitive bidding for 18 to 24 months only. Pharmacists must still obtain facility accreditation to sell DMEPOS, including diabetes supplies.
- I don’t have to obtain facility accreditation because diabetes testing supplies aren’t DME like hospitable beds or wheelchairs?
- False – DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) INCLUDES diabetes testing supplies. Therefore, you MUST obtain facility accreditation to continue to sell diabetes testing supplies.
- Private Insurers (i.e. Blue Cross, HMOs, state Medicaid programs, etc.) do not require DMEPOS accreditation to bill for diabetes testing supplies?
- False – Many states and private insurers are requiring DMEPOS accreditation to participate in their networks or to collect co-pays from dually-eligible Medicare beneficiaries.
- Even though I do not bill Medicare for any diabetes testing supplies, I must still obtain facility accreditation because I bill Medicare for Medicare for Part B drugs and flu shots?
- False – Pharmacist DO NOT have to obtain DMEPOS accreditation, if they are ONLY billing Medicare for Part B drugs and vaccinations. However, pharmacists MUST update their file with the National Supplier Clearinghouse (NSC) by choosing "Pharmacy" as the supplier type in section 2B, and selecting "Drugs/Pharmaceuticals only" in section 2C of the CMS-855S enrollment form. All other products/services must be removed to assume the accreditation exemption. Failure to update your NSC supplier type may be considered as fraud by CMS.
- Where can I acquire current information on Medicare Diabetes Testing Supply Fees?
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Accreditation & Regulation 
