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| Supplies and Accessories - Usual Maximum Amounts â€" December 2009 Many of the DME MAC local coverage determinations (LCDs) have supplies or accessories with usual maximum quantities and frequency limits. Suppliers are not required to provide these amounts nor are beneficiaries required to accept supplies or accessories at this frequency or in quantities that exceed the amount they typically use. Reordering of supplies and accessories is based upon actual beneficiary usage. Suppliers must not dispense a quantity of supplies exceeding a beneficiary's expected utilization. Suppliers should stay attuned to atypical utilization patterns on behalf of their clients and verify with the ordering physicians that the atypical utilization is, in fact, warranted. A beneficiary or their caregiver must specifically request refills of supplies before they are dispensed. The supplier must not automatically dispense a quantity of supplies on a predetermined basis, even if the beneficiary has "authorized" this in advance. As referenced in the Program Integrity Manual (Internet-Only Manual, CMS Pub. 100-8, Chapter 4.26.1) Contact with the beneficiary or designee regarding refills should take place no sooner than approximately 7 days prior to the delivery/shipping date. For subsequent deliveries of refills, the supplier should deliver the DMEPOS product no sooner than approximately 5 days prior to the end of usage for the current product. |
| Remember! National Government Services' Jurisdiction B DME MAC List Serve is for out going messages only. Please do not respond back to messages as your response will not be answered, as this is not an authorized mode of communication at this time, Thank you! National Government Services encourages all Web site users to provide feedback regarding ways to improve our Web site. The ForeSee Results (pop-up) survey is an easy mechanism for providers to use to let us know how we can best serve you. Your comments play a large role in the enhancements that are made to the National Government Services Web site. CONFIDENTIALITY NOTICE: This E-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply E-mail and destroy all copies of the original message. To unsubscribe/change profile: click here. |
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