DMEPOS Standards

NABP’s DMEPOS Pharmacy Accreditation standards are inclusive of the CMS quality standards. The quality standards are guidelines used by the CMS-approved accrediting organizations to which suppliers must comply to attain DMEPOS Pharmacy Accreditation.

Drugs Associated with Durable Medical Equipment

Drugs used with durable medical equipment (DME), for example, inhalation drugs, drugs infused with a DME pump, are not subject to CMS quality standards. If a pharmacy supplies drugs used with DME but does not supply items subject to CMS quality standards, it will not need DMEPOS Pharmacy Accreditation. Medicare Part B drugs identified in section 1861(s) of the Social Security Act (eg, immunosuppressive drugs, oral anti-emetic drugs) are not subject to the quality standards.

However, home dialysis supplies, nutrients furnished using enteral or parenteral devices, blood products, and transfusion medicine are subject to the quality standards. Suppliers of these products will need to attain DMEPOS Pharmacy Accreditation if they wish to maintain Medicare billing privileges.

Items Subject to CMS Quality Standards

DMEPOS Products Approved for Accreditation by NABP

NABP’s DMEPOS Pharmacy Accreditation program is best suited to pharmacies that distribute DMEPOS products that fall within the program’s scope of accreditation.

NABP is currently approved by CMS to accredit the following product categories from the Medicare Enrollment Application:

Devices & Equipment

Mobility Assistance Equipment

• Canes
• Crutches
• Seat Lift Mechanisms
• Walkers

Prosthetics & Orthotics

• Diabetic Shoes/Inserts (Custom & Non-custom)
• Breast Prostheses and/or Accessories
• Othoses

Other

Contact the National Provider Enrollment (NPE) DMEPOS contractors (east and west) or your DME Medicare Administrative Contractor for information on product category-specific information and billing questions. When selecting product categories, facilities must consider the applicable licensure requirements and know which product categories are included in the competitive bidding programs of their service area.

Competitive Bidding

The DMEPOS competitive bidding program is designed to help lower out-of-pocket costs and improve access to certain high-quality DMEPOS products for Medicare beneficiaries. The competitive bidding program was mandated through the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 through a statute that requires Medicare to replace its fee schedule with a competitive bid process.

The competitive bid payment amounts are determined by using bids submitted by DMEPOS suppliers. The intent of the competitive bidding program is to set more appropriate payment amounts for DMEPOS items, which will result in reduced beneficiary out-of-pocket expenses and savings to taxpayers and the Medicare program. To participate in the Medicare DMEPOS competitive bidding program, suppliers must be accredited by a CMS-approved accreditation organization, meet licensing requirements, and, if applicable, become bonded; additional requirements may apply. Please note that DMEPOS Pharmacy Accreditation is required to participate in the DMEPOS competitive bidding program.