Moratorium on new supplier enrollment
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Some late breaking news from CMS requires a slight delay in Part 2 of the elements of documentation of neurological workup to substantiate the need for AFO.
Last week, the President announced a new war against fraud during his State of The Union Address. It did not take long after that announcement for the hammer to come down against DME fraud. In a rather stunning announcement, CMS effectively blocked new supplier enrollment for 7 categories of medical suppliers for at least 6 months.
Most readers of this column will however fit into several categories of exceptions for which this moratorium DOES NOT apply!
Physicians (which includes DPM, DO and DPM and Optometrists) as well as other professional service providers (e.g. Pharmacies, Orthotists, Prosthetists and Pedorthists) are exempt from this moratorium.
This bears repeating, Physicians, including all categories of physicians, are exempt from this moratorium.
The moratorium will affect 7 categories of medical supply companies. These companies may have as their CEO, Medical Director, CFO etc. physicians, orthotists, prosthetists, etc.
Medical supply companies have their principal business supplying DME, whereas physicians have their main job focuses on providing medical/surgical patient care.
In other words, the moratorium does not negatively affect physicians whose main business is not providing DME, but who are providing DME as an ancillary service to their professional medical practices.
Thus, this moratorium will have little if any negative impact on physicians who wish to add a practice location or have no DME license and wish to enroll as a DME provider. This moratorium may have a positive unintended consequence for professionals wishing to add DME to their practice or add an additional location. A moratorium on commercial DME suppliers may allow for enrolment personnel to instead attend to credentialing professional medical providers.
The moratorium on credentialing medical supplies is in place from 2/27/26 through at least 8/27/26.
Something had to be done about the amount of DME fraud, most often committed by offshore commercial DME medial suppliers. The primary impact of this moratorium will be on DME supply companies who wish to add an additional location or block new DME businesses from entering the market—unfortunately, they are the collateral damage as have been us, the taxpayers who fund the Social Security and Medicare Trust Funds. Hopefully this moratorium will work!
To sum up: Most (if not all) readers of this column are providing DME to their patients as an ancillary service to their patients as physicians, orthotists or pedorthists. This moratorium will have no negative effects on your ability to practice and provide your patients with orthotics and prosthetics.
