Obtaining a surety bond for DME suppliers that bill for Medicare servicesOn November 28, 2018 Medicare has implemented a new requirement for all Dental Sleep Medicine (DSM) professionals whose location(s) are currently enrolled as a Medicare DME supplier (or are currently in the process of enrolling their location(s) as a Medicare DME supplier location) to secure a $50,000 surety bond, and provide proof of this bond to the National Suppliers Clearinghouse (NSC) Medicare Administrative Contractor (MAC). Previously, DSM professionals were deemed exempt from this surety bond requirement.
What this means for your practice
- All existing Medicare DME supplier locations will be receiving a letter from CMS Palmetto GBA instructing you to get a surety bond with in a 60-day time frame and submit proof to the National Supplier Clearinghouse. If compliance to this rule is not met your PTAN number will be deactivated.
- If you are currently in the process of getting approval for your DME application, your approval will be delayed until you can show proof of the surety bond.
- Those applicants that are in the pending status of the approval process will receive a notification that you will have 30 days to meet compliance or the application will be denied.
- If you already have a surety bond, submit proof to the National Supplier Clearinghouse https://www.palmettogba.com/nsc
What can you do if your application gets denied?
- If your application is denied because you have not obtained the surety bond you will have 30 days to submit a corrective action plan along with the proof of the surety bond, to the appeals department.
- The appeals department will then review all the submitted paperwork and determine if all requirements are met, and your application will be put back into process. This will cause a significant delay in getting your application approved.
Where can I get a Surety Bond?
The surety bond must be obtained from a federally approved surety company. You can find a list of these companies at: https://www.fiscal.treasury.gov/surety-bonds/list-certified-companies.html
The cost of surety bonds varies depending on the amount of the bond and credit of the applicant.
We have provided the contact information for a Medicare approved surety bond agent below:
Sonja Amanda Floree Harris - Commercial Surety Manager
Why did this change?
Palmetto GBA released the following statement to explain this new requirement:
Pursuant to 42 CFR § 424.57(d)(15)(i)(C) Physicians and non-physician practitioners as defined in section 1842(b)(18) of the Act are provided an exception to the surety bond requirement when items are furnished only to the physician or non-physician practitioner's own patients as part of his or her physician service. In recent years the NSC has seen a spike in the enrollment of Dentists for DMEPOS services. As physicians, dentists were initially allowed the exemption for the surety bond requirement. However, as most dentists are providing items that have been prescribed by other providers, it has been determined that they do not meet the requirements of this exemption. Note that 42 CFR § 424.57(d)(15)(ii) states a DMEPOS supplier that no longer qualifies for an exception as described in paragraph (d)(15)(i) of this section must submit a surety bond to the CMS contractor in accordance with requirements of paragraph (d) of this section within 60 days after it knows or has reason to know that it no longer meets the criteria for an exception.