What You Need to do if You Are Not Going to be Accredited or Get a Surety Bond
If you will not become accredited or secure a surety bond by the required dates, October 1, 2009, and October 2, 2009, respectively, or have made the business decision not to obtain accreditation or a surety bond if required, you may want to voluntarily terminate your enrollment with the Medicare program as a DMEPOS supplier to avoid revocation and its consequent enrollment bar. To voluntarily terminate complete sections 1B, 4A, 13, and either 15 or 16 of the (03/09) version of the CMS-855S enrollment form, a hardcopy of the voluntary termination CMS-855S signed and dated on or before October 1, 2009, or October 2, 2009, with the original signature of the authorized or delegated official on file must be sent to the NSC on or before October 1 or October 2, 2009. Suppliers should be prepared to provide documentary evidence that the voluntary termination request was submitted on or before October 1 or October 2, 2009.
If you decide to voluntarily terminate your enrollment and later decide to re-enroll in the Medicare program, you will only be able to bill for services furnished on or after the date the NSC issues a DMEPOS PTAN (formerly supplier number) to you conveying billing privileges. In most cases, this will result in a substantial period for which you, as a DMEPOS supplier, cannot bill for services furnished to Medicare beneficiaries.
Suppliers who do not plan to remain enrolled in the Medicare program are strongly encouraged to notify their customers as soon as possible. This will give your customers an opportunity to find another DMEPOS supplier. A sample letter to beneficiaries can be found on the NSC Web site in the sample letters section.