DMEPOS Frequently Asked Questions

  1. Is DMEPOS accreditation mandatory?
  2. How long is DMEPOS accreditation valid?
  3. I only dispense Medicare Part B drugs, no DMEPOS products or services. Do I need to be accredited to keep my provider number?
  4. What is a Surety Bond? Is it a requirement for DMEPOS accreditation?
  5. Do I need to prepare a manual in order to become accredited by NABP?
  6. How often will surveys be performed?
  7. What is the NABP procedure for addressing disputes?
  8. What are the responsibilities of NABP as an accrediting organization?
  9. What are the responsibilities of pharmacies seeking accreditation through NABP?
  10. What do I need to do during the annual compliance review?
  11. What is the DMEPOS reaccreditation process?
  12. What if I do not plan to renew my pharmacy’s accreditation during the annual compliance review?
  13. What is pharmacy accreditation exemption and how do I qualify?
  14. What is the difference between the Medicare DMEPOS Supplier Standards and the CMS DMEPOS Quality Standards?

NABP E-Profile Assistance

  1. What is an e-Profile?
  2. I am a facility, not an individual. How do I obtain an e-Profile ID

1. Is DMEPOS accreditation mandatory?

DMEPOS accreditation is required for suppliers who wish to obtain or maintain Medicare Part B billing privileges for products and services that are subject to CMS’s Quality Standards. New DMEPOS suppliers must be accredited before an NSC number can be sought.

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2. How long is DMEPOS accreditation valid?

DMEPOS accreditation is valid for 3 years. DMEPOS-accredited pharmacies undergo an annual participation compliance review in years 2 and 3.

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3. I only dispense Medicare Part B drugs, no DMEPOS products or services. Do I need to be accredited to keep my provider number?

Drugs used with DME (eg, inhalation drugs, drugs infused with a DME pump) are not subject to CMS Quality Standards or accreditation. Likewise, other Part B drugs identified in section 1861(s) of the Act (eg, immunosuppressive drugs, oral anti-emetic drugs) are not subject to the Quality Standards or accreditation either. Thus, pharmacies that dispense only Part B drugs and do not furnish any DMEPOS subject to the CMS Quality Standards do not need to be accredited.

Although accreditation is not required to dispense products not subject to the Quality Standards, suppliers are required by the NSC to obtain/maintain a Medicare Billing Number by submitting or updating a Medicare Enrollment Application. Please contact the NSC for information about enrollment options via the internet-based PECOS or the CMS-855S form (paper enrollment form). Call the toll-free phone number at 1-866/238-9652 from 9 AM until 5 PM EST to reach a customer service representative. The automated response system is available 24 hours a day.

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4. What is a Surety Bond? Is it a requirement for DMEPOS accreditation?

A DMEPOS surety bond is a bond issued by an entity (the surety) guaranteeing that a DMEPOS supplier will fulfill an obligation or series of obligations to a third party (the Medicare program). If the obligation is not met, the third party will recover its losses via the bond. DMEPOS suppliers enrolled in Medicare are required to obtain and submit a $50,000 bond for each National Provider Identifier (NPI) to the NSC. See the NSC’s Surety Bond FAQ for more information or visit the US Department of Treasury website for a list of certified surety bond companies.

While the surety bond is not required for accreditation, it is required to retain your Medicare billing number.

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5. Do I need to prepare a manual in order to become accredited by NABP?

A manual, per se, is not required. However, the pharmacy should have the policy and procedures available at the pharmacy for reference via hard copy or email.  All supporting documentation and policy and procedures requested with the application must be submitted to NABP for review prior to the unannounced survey. For a list of the required supporting documentation, please review the application instructions; guidance information for preparing supporting documentation is provided in the online application.

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6. How often will surveys be performed?

CMS requires that a supplier undergo an unannounced survey once every three years following accreditation to evaluate the supplier’s performance and ensure compliance with CMS quality standards. NABP performs ongoing compliance monitoring during the accreditation cycle, which could involve an unannounced on-site survey. In addition, complaints (from any beneficiary, regulatory agency, or CMS) and/or a change in critical operations or business structure, such as a change in ownership, could also prompt an unannounced on-site survey.

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7. What is the NABP procedure for addressing disputes?

The DMEPOS accreditation team is here to help you through the accreditation process. The appeals procedure sets forth the process for DMEPOS suppliers to appeal a decision to deny or remove accreditation.

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8. What are the responsibilities of NABP as an accrediting organization?

  • Consider any previous accreditation, certification, and/or licensure findings that indicate that DMEPOS quality standards are being met at the time the accreditation organization surveys the supplier.
  • Use a streamlined process that considers only compliance with CMS Quality Standards.
  • Notify CMS, in writing, of any supplier that has had its accreditation revoked, withdrawn, revised, or any other remedial or adverse action taken against it by the accreditation organization within 30 calendar days of any such action taken.
  • Notify all accredited suppliers within 10 calendar days of CMS’s withdrawal of the organization’s approval of deeming authority.
  • Notify CMS, in writing, at least 30 calendar days in advance of the effective date of any proposed changes in accreditation requirements.
  • Submit to CMS, within 30 calendar days of a change in CMS requirements, an acknowledgement of CMS’s notification of the change, as well as a revised crosswalk reflecting the new requirements, and inform CMS about how the organization plans to alter its requirements to conform to CMS’s new requirements.
  • Permit its surveyors to serve as witnesses if CMS takes an adverse action based on accreditation findings.
  • Notify CMS, in writing, within two calendar days of a deficiency identified in any accreditation entity where the deficiency poses an immediate jeopardy to the entity’s beneficiaries or a hazard to the general public.
  • Provide, on an annual basis, summary data specified by CMS that relates to the past years’ accreditations and trends.
  • Attest that the organization will not perform any DMEPOS accreditation surveys of Medicare-participating suppliers with which it has a financial relationship or interest.
  • Ensure that NABP’s accreditation requirements conform to changes in Medicare requirements.

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9. What are the responsibilities of pharmacies seeking accreditation through NABP?

As an applicant, the pharmacy’s responsibilities include:

  • Prepare and submit all required documentation.
  • Inform NABP of all DMEPOS products and services provided to beneficiaries or any change in the product categories for which the NABP-accredited supplier is already accredited.
  • Advise NABP in writing within 30 calendar days of changes to your submitted application that include:
    • Change in ownership
    • Change in pharmacist-in-charge
    • Major change in physical structure of facility
    • Change in location
    • Any significant changes to the application information already provided to NABP
    • Merger or acquisition

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10. What do I need to do during the annual compliance review?

Once a year, the accredited supplier will confirm its ongoing DMEPOS accreditation compliance. During this time, NABP may follow up on items remediated during the accreditation cycle or provide new information or updates. NABP will also review licensure for the pharmacy and pharmacist-in-charge to confirm good standing. During the third year of your accreditation cycle, NABP will contact you about the reaccreditation process and steps needed to promote accreditation continuity.

Visit the Maintaining Accreditation page for more information.

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11. What if I do not plan to renew my pharmacy’s accreditation during the annual compliance review?

If you do not want or need DMEPOS reaccreditation, please inform NABP electronically or in writing. Visit the Maintaining Accreditation page for more information.

Please note: DMEPOS accreditation is required to participate in the DMEPOS Competitive Bidding Program and the Mail Order Competition for diabetic testing supplies.

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12. What is the DMEPOS reaccreditation process?

DMEPOS suppliers must be reaccredited before the current accreditation expires if DMEPOS accreditation is required for your pharmacy. Unless a pharmacy has received a pharmacy accreditation exemption confirmation from the NSC, we encourage suppliers to seek reaccreditation for a new, three-year accreditation during the final year of their DMEPOS accreditation.

Visit the Maintaining Accreditation page for more information.

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13. What is pharmacy accreditation exemption and how do I qualify?

As of January 1, 2011, pharmacies that meet certain criteria may file an accreditation exemption statement with the NSC to seek exemption from the DMEPOS accreditation requirement. Pharmacy exemption information can be found on the NSC website.

The NSC recommends that “you continue accreditation until you have received notice of acceptance of your accreditation exemption statement from the NSC” because “if you are no longer accredited and do not qualify for the exemption, your Medicare billing privileges will be revoked.”

Please inform NABP in writing if you have received pharmacy exemption status from the NSC and no longer want to remain DMEPOS-accredited. If a pharmacy informs NABP of their pharmacy exemption status and does not wish to maintain the DMEPOS accreditation:

  • DMEPOS accreditation information for your pharmacy will no longer be provided to CMS.
  • Your DMEPOS accreditation file will be closed and the letter of agreement terminated.
  • Once your file is closed you may reapply for accreditation at a later date by submitting a new application, required documentation, and any applicable accreditation and administrative fees. A minimum of six months is typically required to complete an accreditation.

Please note: DMEPOS accreditation is required to participate in the DMEPOS Competitive Bidding Program and the Mail Order Competition for diabetic testing supplies.

NABP is not involved in the pharmacy exemption process and questions regarding pharmacy exemption should be directed to the NSC.

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14. What is the difference between the Medicare DMEPOS Supplier Standards and the CMS DMEPOS Quality Standards?

Medicare DMEPOS suppliers must be compliant with all Medicare DMEPOS Supplier Standards in order to obtain their Medicare Billing Number and retain billing privileges. The NSC is responsible for ensuring compliance with the Supplier Standards.

DMEPOS Suppliers must demonstrate compliance with the CMS Quality Standards and other corresponding Accreditation Organization Program Standards in order to be awarded DMEPOS accreditation.

Accredited DMEPOS suppliers must therefore be in compliance with both the Medicare DMEPOS Supplier Standards and the CMS Quality Standards.

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NABP E-Profile Assistance

1. What is an e-Profile?

The NABP e-Profile system allows individuals to easily manage their participation in NABP programs. At present, the system is used by pharmacists, pharmacy technicians, and pharmacy students to easily manage their participation in NABP programs and to track continuing pharmacy education. They are all provided with a unique e-Profile ID when they create their account.

Additionally, states may require facilities to provide e-Profile IDs so that they may access discipline and other information that is shared between states and managed by NABP in the e-Profile system. (See FAQ #2 below for information on obtaining a facility e-Profile ID.)

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2. I am a facility, not an individual. How do I obtain an e-Profile ID?

At present, it is not possible for a facility to create its own e-Profile ID. However, NABP can assist your facility by creating the number, if necessary. It is possible that, unbeknownst to a facility, it may have already been assigned an e-Profile ID. To determine if your facility either has an e-Profile or if NABP needs to create one on your facility’s behalf, please send the following information to dmepos@nabp.pharmacy:

  • Legal Business Name (typically filled with resident state’s Secretary of State)
  • Doing Business as Name
  • Facility Address
  • FEIN
  • NCPDP ID (if applicable)
  • Resident State License Number

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