Provider Notice issued 11/24/15

Chapter M-200, Handbook for Providers of Medical Equipment and Supplies Update to Topic M-205, Record Requirements, Effective January 1, 2016

Provider Bulletin M-200 15-01

Pursuant to Public Act 96-1530, long term care providers are to be assessed an amount equal to $6.07 times the number of occupied bed days due and payable each month. An "occupied bed day" is defined as the sum of all beds multiplied by the number of days during the month on which each bed was occupied by a resident, other than a resident for whom Medicare Part A is the primary payer. By law, this assessment cannot be billed or passed on to any resident of a nursing home.

•  Providers who dispense equipment or supplies on a monthly basis must confirm orders each month prior to dispensing. The confirmation should document the number of items needed as well as the name of the specific items needed for the subsequent month. Providers must speak to a patient, family member, or caregiver to ensure only those items and quantities needed are shipped. Orders not confirmed should not be dispensed. Confirmation calls must be made no more than 14 calendar days prior to the scheduled shipment day of the equipment or supply items. 

•  Suppliers are also required to maintain proof of delivery documentation in their files.  Proof of delivery is required in order to verify the participant received the equipment or supply items.

• In addition, in the case of medical supplies, the provider must be able to document purchases of sufficient quantities of the items to support the volumes dispensed and billed. In the case of durable medical equipment or prostheses, the provider must be able to provide a copy of the original wholesale purchase invoice for the item and records of any customization performed by the provider.

Additional details regarding these new requirements are contained in the revised language for handbook Topic M-205. The Handbook for Providers of Medical Equipment and Supplies has been updated and is available on the department’s website.

Any questions regarding this bulletin should be directed to a medical assistance consultant in the Bureau of Professional and Ancillary Services at 1-877-782-5565.

Instructions for updating the Handbook for Providers of Medical Equipment and Supplies:

Topic M-205  Record Requirements

Remove pages HFS M-205 (1-2) and insert new pages HFS M-205 (1-2)

DME Topic 205 Revision Pages