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Additional guidance regarding the ordering of medical equipment, supplies and appliances

The Division of Medicaid shares the concerns of providers who believe the physician order requirement in 42 C.F.R. § 440.70 may pose an additional barrier to needed services and care.  The agency is actively working with Centers for Medicare and Medicaid Services (CMS) and other stakeholders to address these concerns.

According to written guidance, CMS will defer to Mississippi’s collaborative practice agreement procedures regarding the ordering of medical supplies, equipment and appliances.  Therefore, if the collaborative agreement allows the non-physician practitioner to order medical supplies, equipment and appliances, the non-physician practitioner’s signature on the order is sufficient and the collaborating physician is not required to sign or co-sign that order for the medical supplies, equipment and appliances to be covered by the Division of Medicaid. The durable medical equipment (DME) provider must include the collaborating physician’s national provider identifier (NPI) number on (1) any required prior authorization requests submitted to Utilization Management/Quality Improvement Organization (UM/QIO) vendors, and (2) all claims submitted to the Division of Medicaid or Coordinated Care Organizations (CCOs) in accordance with 42 C.F.R. § 455.440.  Additionally, as a reminder, 42 C.F.R. § 455.410 requires that all ordering or referring physicians must be enrolled as Mississippi Medicaid providers.

Providers will be receiving more education materials prior to the September 1, 2018, effective date.  If you have any questions, please contact the Office of Medical Services at 601-359-6150.

For more information, please read the letter to providers from the Executive Director.

Posted June 22, 2018.

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