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Surety bonds required for dentists enrolled as DMEPOS suppliers

July 22, 2019 4779

Beginning June 1, the National Supplier Clearinghouse began sending letters to Medicare-enrolled dentists notifying them that a surety bond of at least $50,000 per office location may be required to initiate or continue their Medicare enrollment as a supplier of durable medical equipment, prosthetics, orthodontics and supplies. Prior to 2019, dentists were exempt from this rule, “Medicare Program: Surety Bond Requirement for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS),” published by the U.S. Centers for Medicare & Medicaid in 2009.

According to the Centers for Medicare & Medicaid, as of April 2019, 1,365 dentists were enrolled as DMEPOS suppliers in Medicare, which amounts to an estimated 100 dentists in California who should have received the letter. CDA Practice Support and The Dentists Insurance Company report that some members upon receipt of the letter have called with questions about their obligations and whether they meet the surety bond exception 42 CFR 424.57(d) (15)(i)(c).

Because a dentist acts exclusively as a DMEPOS supplier when furnishing an oral appliance prescribed by another practitioner, the dentist will not typically qualify for the surety bond exception. Similarly, dentists who supply DMEPOS and perform tasks that involve device fitting and assessing the patient for that device do not meet the exception in the regulation that applies “only to services in which the diagnosis, prescription and fitting occur ‘as part of’ the physician service,” according to the CMS fact sheet dated June 1.

For example, oral appliance therapies for sleep apnea are considered DMEPOS items that require a written order from the treating physician. As such, dentists who are furnishing oral appliances for sleep apnea are required to have and maintain a surety bond of at least $50,000 per office location.

In other terms, as reported June 17 by the ADA, “CMS said the surety bond exception only extends to physicians who are both prescribing and filling the product in the course of their own ‘physician service.’”

The letter from National Supplier Clearinghouse outlines one of three actions that the supplier must take within 60 days of the date of the notice:

  • Provide proof of a valid surety bond.
  • Voluntarily terminate their DMEPOS enrollment.
  • Provide proof that all DMEPOS items provided are for the supplier’s own patients as part of their physician service.

CMS notes in its fact sheet that it will deactivate suppliers’ billing privileges if they fail to obtain, timely file or maintain the specified surety bond.

Members who received the letter and have additional questions or who need assistance in securing the bond can contact TDIC at 800.733.0633.

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