To maintain billing privileges for Medicare-covered items, accredited suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) must obtain continuing Medicare DMEPOS supplier surety bonds. Medicare bond requirements were created by the Centers for Medicare & Medicaid Services (CMS) in 2009 to protect the government from suppliers missing payments for claims, assessments, and penalties. The minimum amount for a DMEPOS supplier bond is $50,000, and a separate bond is required for each of a supplier’s practice locations that has a unique National Provider Identifier (NPI) number. The ProSure group is an authorized surety issuing DMEPOS supplier bonds in Florida as low as 0.5 percent of the total bond amount. Contact us to request a free bond quote!
Medicare billing privileges are reserved for certified DMEPOS suppliers. To maintain certification, suppliers must meet the thirty Medicare DMEPOS supplier standards outlined in 42 CFR § 424.57. Twenty-sixth among them is the surety bond requirement, which applies in several cases.
New DMEPOS suppliers who wish to enroll in Medicare billing privileges must obtain surety bonds of at least $50,000 for each NPI. Proof of the bond must be made available at the time of an application’s submission.
New owners who purchase or receive the assets of enrolled DMEPOS suppliers are required by CMS to provide updated surety bonds naming the new principals. New bonds must also account for any elevated bond amounts set previously by CMS contractors. The effective date for a surety bond should correlate to the start date of the supplier’s billing privileges.
Current DMEPOS suppliers who are enrolling additional practice locations with new NPI numbers must provide new surety bonds for each. Alternatively, the suppliers can add riders showing modified amounts (at least $50,000 per location) to existing Medicare bonds.
Certain DMEPOS suppliers are exempt from Medicare bond requirements. Such bond exceptions may apply to government-owned DMEPOS suppliers who have comparable surety bonds under state law; certain state-licensed, private-practice orthotic and prosthetic providers who make custom orthotics; and (non-)physician practitioners and physical therapists who provide DMEPOS supplies only as a professional service. Laws surrounding Medicare bonds exemptions change over time. Suppliers who lose exempt status have 60 days to supply the necessary bonds or risk loss of billing privileges. Our surety bond experts are up-to-date on current laws involving Medicare bonds. Contact us to learn which bond requirements or exemptions you qualify for.
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Florida DMEPOS supplier surety bonds have a base of $50,000 for each practice location with a distinct NPI number. A supplier with three locations, for example, must furnish three $50,000 surety bonds equalling $150,000. That sum could also be reached through one initial $50,000 bond with two $50,000 riders attached (or two bonds, one with a rider). CMS contractors also have the authority to increase DMEPOS suppliers’ bonds by $50,000 for each time the suppliers committed an adverse legal action within the past 10 years of their enrollment.
Aside from a base amount of $50,000, Florida DMEPOS supplier surety bond must comply with other terms and conditions. The bonds must be continuous — most surety bonds have one-year coverage periods and are renewed annually — and maintained for as long as the suppliers remain enrolled in Medicare billing privileges. The bonds’ liability coverage must meet the CMS contractors’ requirements, including having guarantees of payment within 30 days of receiving notices with evidence of unpaid claims, assessments, or civil monetary penalties (CMPs). A DMEPOS surety bond should name the supplier as the principal, the CMS as obligee, and the surety company as surety, and be submitted to the CMS contractor with the enrollment application.
If enrolled DMEPOS suppliers let their surety bond coverages lapse, they risk losing their Medicare billing privileges immediately. By law, the surety must notify the CMS contractor when a DMEPOS supplier’s bond lapses. The contractor then revokes the supplier’s privileges on the same day. The average coverage period for a DMEPOS supplier surety bond in Florida is one year, but the bonds are renewable for long as the supplier is enrolled. Alternatively, if a DMEPOS supplier wishes to cancel a surety bond, they must first notify the CMS contractor and the surety at least 30 days ahead of time.
Not all sureties are created equal. When you shop for a surety bond in Florida, the terms of approval and rates you qualify for will be based on your credit score and other financial records, but they’ll also depend on the surety company. The ProSure Group offers Florida Medicare bonds for the lowest market rates available. Even if you have a DMEPOS supplier bond already, as long as it doesn’t expire for at least 30 days, you can still apply for a better rate through us. So whether you’re seeking enrollment in Medicare billing privileges, starting a new practice location, or shopping around for a lower bond rate, let our surety professionals help you find the surety bond you need!