Dentists who provide durable medical equipment and who participate in a CMS billing program now must submit a DMEPOS surety bond, according to a new requirement the Centers for Medicare and Medicaid Services released in Nov. 2018.
A DMEPOS surety bond is a license and permit surety bond required by CMS for all suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), as detailed in 42 CFR § 424.57. The final rule was published in the Federal Register on Jan. 2, 2009.
The surety bond must be in an amount that is not less than $50,000, according the Act. Each National Provider Identifier (NPI) requires a separate bond.
Under the Act, physicians and non-physician practitioners are given an exception to the surety bond requirement when items are furnished only to the physician or non-physician practitioner’s own patients as part of their physician service. Previously, dentists were allowed this physician exemption.
In recent years, the National Supplier Clearinghouse – where suppliers are required to submit their bonds – has seen a spike in the enrollment of dentists for DMEPOS services, according to Palmetto GBA, LLC. So, as most dentists are providing items that have been prescribed by other providers, the Center for Medicare and Medicaid Services determined they do not meet the requirements of this exemption.
Purposes of the DMEPOS surety bond:
- Limit the Medicare program risk to fraudulent suppliers
- Enhance the legitimacy of the Medicare enrollment process and current suppliers
- Ensure the Medicare program is indemnified for erroneous payments resulting from fraudulent or abusive supplier billing practices
- Ensure Medicare beneficiaries receive reasonable products and services from legitimate suppliers
The American Dental Association sent a letter Jan. 31 to Centers for Medicare and Medicaid Services on behalf of its 163,000 members, asking for clarification.
The association also requested that, “dentists be provided the same exception as physicians as to the surety bond requirement pursuant to 42 CFR 424.57(d)(15)(i)(C) of the Act,” according to the letter.
The Act states that a current DMEPOS supplier must submit a surety bond in accordance with requirements within 60 days after it knows or has reason to know that it no longer meets the criteria for an exception.
The penalty for not complying is the deactivation of your Medicare Provider Transaction Access Number (PTAN).