​MEDICARE SUPPLIER STANDARDS and Emergency Plan for our patients

Below we have posted the Medicare Supplier Standards. Please note that this is an abbreviated version of the supplier standards every Medicare supplier must meet in order to obtain and retain its billing privileges. These standards, in their entirety, are listed in 42 C.F.R. 424.57(c).
MEDICARE SUPPLIER STANDARDS

1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements and cannot contract with an individual or entity to provide licensed services.
2. A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.
3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.
4. A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or from any other Federal procurement or non-procurement programs.
5. A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.
6. A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.
7. A supplier must maintain a physical facility on an appropriate site. This standard requires that the location is accessible to the public and staffed during posted hours of business. The location must be at least 200 square feet and contain space for storing records.
8. A supplier must permit CMS, or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.
9. A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll free number available through directory assistance. The exclusive use of a beeper, answering machine, answering service, or cell phone during posted business hours is prohibited.
10. A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.
11. A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from contacting a Medicare beneficiary based on a physician’s oral order unless an exception applies.
12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.
13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.
14. A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company, Medicare-covered items it has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.
17. A supplier must disclose to the government any person having an ownership, financial, or control interest in the supplier.
18. A supplier must not convey or reassign a supplier number; i.e., the supplier may not sell or allow another entity to use its Medicare billing number.
19. A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards. A record of these complaints must be maintained at the physical facility.
20. Complaint records must include: the name, address, telephone number, and health insurance claim number of the beneficiary, a summary of the complaint, and any actions taken to resolve it.
21. A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.
22. All suppliers must be accredited by a CMS-approved accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services, for which the supplier is accredited in order for the supplier to receive payment of those specific products and services (except for certain exempt pharmaceuticals).
23. All suppliers must notify their accreditation organization when a new DMEPOS location is opened.
24. All supplier locations, whether owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare.
25. All suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation.
26. All suppliers must meet the surety bond requirements specified in 42 C.F.R. 424.57(c).
27. A supplier must obtain oxygen from a state-licensed oxygen supplier.
28. A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C.F.R. 424.516(f).
29. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.
30. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.

Emergency plan

OLICY:  In order to provide continuing care or services in the event of a natural disaster or any other circumstances which would interrupt the provision of home care services, Fairway Medical maintains an Emergency Preparedness Plan.

PROCEDURE:

1. A telephone tree is established using the organizational chart.  In the absence of telephone service, other forms of communication such as radio announcements and cellular telephones will be used to provide public information and inform staff of the plan of action.  The Manager or designee will initiate the telephone tree.
2. Communication between management and staff will be made by telephone, pager, cellular telephone or in person, as dictated by the particular circumstances.
3. Patients are classified according to the acuity of their medical condition, nursing needs and caregiver availability upon admission.  This classification will be used to triage patients at the time of a disaster.  Patients will be classified into one of the following categories, Class 1, Class 11 or Class 111.  This will be entered on the census sheet and updated as needed.  A current census sheet will be kept at the office and with the Manager for On-Call purposes. If a home visit is not possible to those patients in Class 1, the Manager will coordinate with the local     sheriff’s office, emergency operations center or local ambulance service to transport the patient to an acute care facility.

• Class 1-  High risk patients:  The fire department and power company will be notified of electrically       dependent and disabled patients on admission.
• Class 11-  Moderate risk patients: Services can be postponed for 24-48 hours without adverse effects.  
• Class 111- Low risk patients:  Services could be postponed for 72-96 hours without adverse effects.

1. If phone service is not operating and roads are impassable for travel, staff should stay home or another safe place until communications are restored.
2. If the Manager is unable to reach the office in person, the communication center will be at his/her home.
3. In the event of loss of phone service for an extended time, local radio and television stations will be utilized to communicate the emergency plan.
4. Whenever possible, attempts will be made to keep the clients appraised of the situation.
5. If an employee is at the home of a patient in the event of a disaster, she/he will provide for, if possible, the immediate removal of the patient and their family from the area.
6. As soon as operations are normalized, the physician will be notified of any appropriate communication due to the institution of the emergency plan.  
7. Within two weeks of the implementation of the emergency plan, a conference will be held to evaluate the effectiveness of the plan.

The telephone numbers of emergency services for the area serviced by Fairway Medical are:

Red Cross 
 4747 N 22nd St #100, Phoenix, AZ 85016
 (602) 336-6660

County Emergency Management 
5630 E McDowell Rd, Phoenix, AZ 85008
(602) 273-1411

Public Health Department- Division of Emergency Management 
4041 N Central Avenue
Phoenix, AZ 85012
Phone 602-506-6767

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