New Rules – Orders for DMEPOS, clinical laboratory & imaging services

On Friday, April 27, 2012, CMS published a notice in the Federal Register detailing the final rule regarding changes to:

  • provider and supplier enrollment,
  • ordering and referring doctors’ identification,
  • documentation requirements, and
  • changes in provider agreements.

The rule becomes effective June 26, 2012.

Of interest to ophthalmologists and optometrists is a requirement that your legal name and NPI number (as registered in PECOS) must now be included on all prescriptions for Medicare-covered items and services. This includes prescriptions for clinical laboratory and imaging services, as well as DMEPOS (i.e., postcataract eyeglasses).[1] The rule also requires that physicians and other professionals who write these prescriptions be enrolled in Medicare. Finally, the rule requires that physicians and other professionals keep documentation of these orders for a period of seven (7) years from the date of service.

The final rule as published in the Federal Register may be accessed at http://www.ofr.gov/(X(1)S(0zb1byigcunulpmhwyfk4g00))/inspection.aspx?AspxAutoDetectCookieSupport=1.

The CMS press release on this issue is available at http://www.cms.gov/apps/media/press/release.asp?Counter=4342&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date.

 

[1] Prescriptions for drugs covered under Medicare Part D already have this requirement.

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