There is always excitement and some fear when the New Year is upon us. The same can be said about the medical insurance landscape as well. Medicare recently issued a development notification that will specifically affect dentists that provide Medicare DME services..

On November 28 a notification was mailed to all Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) providers.

The big question is why does this matter and how are you affected?

Dentists must now carry a Surety Bond in order to provide DME services to Medicare beneficiaries.   Below are additional important details that require your timely action:

  • Surety Bond must provide $50,000 coverage minimum per practice location.
  • You will have 60 calendar days from the date on the notification letter to obtain the Surety Bond.
  • You can obtain a DMEPOS Surety Bond from your current general liability insurance company.
  • If the information is not provided within the allotted time frame your Medicare PTAN will be DEACTIVATED. Once deactivated you will not be able to provide Medicare DME services, and you will need to reapply.

If you are in the process of the Medicare application process you should receive an email from your Medicare Analyst requesting the need of the Surety Bond documentation.  Please review the email notification to ensure that you are adhering to the time frame to produce the request.

This has been a topic of conversation on many different forums. The National Supplier Clearinghouse (NSC) issued an article outlining the change.  The regulations have yet to be updated in 42 CFR § 424.57(d)(15)(i)(C). The notated reason for the update is as follows:  “In recent years the NSC has seen a spike in the enrollment of Dentists for DMEPOS services. Dentists were initially allowed the exemption for the surety bond requirement”. Think about that for a moment! Dentists have impacted Medicare’s DME significantly enough to be defined as a “spike”.  This means that Dental Sleep Medicine is moving the needle! That is a testament to your continued pursuit in providing options to ensure that people do not go untreated.

Medicare can be difficult to navigate.  Your billing service provider will be well versed in the updates and will be a your valuable resource.  They will be the GPS for your practice and get you to the correct place without re-routing. We are always available to provide assistance as needed.

Questions? Contact Lisa Herdt, Director of Billing Services, 4 Pillar Billing.