DME – what is that I remember asking years ago. Durable medical equipment includes such things as walkers, wheelchairs, oxygen, hospital beds etc. It has to provide therapeutic benefit to a patient or serve a medical purpose. It also needs to be ordered by a physician, physician assistant (PA), Certified Nurse Specialist(CNS) or Nurse Practitioner (NP). Medicare will pay for this equipment and it is about 2 percent of Medicare budget. Check your insurance to see if it pays for equipment. If you are on medical assistance, DME is often covered as well. When my mom needed a walker her Medica plan payed the majority of the cost.
Medicare tightened the process to receive medical equipment due to fraud. You might have heard of the scooter and wheelchair fraud case that made national news and was on 60 minutes in 2014.
In 2013 durable medical equipment companies had to go through the competitive bid process to carry medical equipment and be reimbursed by Medicare. The company with the lowest price was awarded the bid. This had some negative outcomes for patients and discharge planners and durable medical equipment companies amoxicillin tablets. The process became more confusing, only certain durable medical companies carried certain equipment, and some chose not to work with Medicare at all. Some companies closed their doors.
With the Affordable Care Act, there must now be a Face to face visit within 6 months of ordering the equipment and 1 month for oxygen and a detailed written order. The detailed written order has to have these elements: patients name, ordering Physician, PA, NP or CNS name and written signature and date, their NPI number and date of the order. It needs to include a detailed description of the item and length of time the equipment will be needed. If lifetime, 99 months is used.
Knowledge is power. If equipment will be needed in the future for your loved one, and they have an appointment with their doctor, ask about this in the appointment so that can constitute as a face to face visit for the equipment. Then later when it is needed a detailed written order can be filled out.
For more information about Durable Medical Equipment that Medicare covers click here.