LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone: 305.436.5030
Fax: 305.436.0086
E-mail Address: info {at] LEEDerGroup [dot] com

2013-05 DMEPOS Information: Supply by Pharmacies Fact Sheet

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Information for Pharmacies
  • To supply Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), a pharmacy must be accredited by a Centers for Medicare & Medicaid Services (CMS)-approved independent national Accreditation Organization (AO) or mustobtain an accreditation exemption from the National Supplier Clearinghouse (NSC). This fact sheet provides information for pharmacies that want to be considered for exemption and provides resources for more information.
  • Pharmacy Accreditation Exemption
    A pharmacy that meets all of the following criteria may file an accreditation exemption statement to supply DMEPOS without being accredited:
    1. The total billings by the pharmacy for DMEPOS are less than 5 percent of total pharmacy sales for the previous 3 calendar years, 3 fiscal years, or other yearly period as specified by the Secretary;
    2. The pharmacy has been enrolled as a supplier of DMEPOS and has had a provider number for at least 5 years;
    3. No final adverse action has been imposed on the pharmacy in the past 5 years;
    4. The pharmacy submits an attestation, as determined by CMS, that it meets the first three criteria; and
    5. The pharmacy agrees to submit materials as requested during the course of an audit conducted on a random sample of pharmacies selected annually.
Total DMEPOS Billings Less Than 5 Percent of Total Pharmacy Sales
  • For the first exemption criterion listed on page 1, total DMEPOS billings must be less than 5 percent of the total pharmacy sales. For example, if a pharmacy is part of a larger location, such as a grocery store with a pharmacy that sells other items, the total DMEPOS sales are measured as a percentage of the total pharmacy sales, not total grocery store sales. A chain pharmacy, defined by the NSC as a pharmacy with more than 25 locations, may not be able to meet the 5 percent exemption criteria. Currently, a chain is accredited as one entity; all the locations get one accreditation decision. The NSC considers the chain’s total pharmacy and DMEPOS sales, including sales from all its locations, when determining whether the chain qualifies for an accreditation exemption. If the total DMEPOS sales are less than 5 percent of the total pharmacy sales, the pharmacy meets the first exemption criterion.
New Locations and Franchise Locations
  • Newly opened locations must be accredited because they do not meet the exemption requirement of having been enrolled in the Medicare Program as a DMEPOS supplier for at least 5 years. Therefore, newly opened locations within chains or single locations must be accredited. If a location is part of a franchise, then that location is not considered a chain; each location must get a separate accreditation decision, if required. Each location that is part of a franchise is reviewed separately to determine whether it meets all of the exemption criteria.

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