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 ID and how do I obtain one?
  2. Is an e-Profile ID required for accreditation or verification through NABP?
  3. How can I confirm if I (or my facility) already have 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.

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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 (also known as the CMS-855S). Please contact the NSC for more information about the CMS-855S form. The toll-free phone number: 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, all supporting documentation requested with the application must be submitted to NABP for review. 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. In addition, a Survey Preparation Guide will be provided to applicants prior to survey.

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6. How often will surveys be performed?

CMS requires that a supplier be reaccredited and undergo an unannounced survey once every three years to evaluate the pharmacy supplier’s performance and ensure compliance with CMS quality standards. 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 prompt an announced on-site survey at other times.

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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’s DMEPOS 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.
  • 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

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

NABP will send annual compliance review materials via email prior to your accreditation anniversary date. The materials include:

  • An annual compliance review form that allows you to confirm or update information and/or documentation on file at NABP.
  • An invoice for the annual compliance fee per facility. Please note: annual compliance fees are not refundable.

Both the fee and completed form must be received by NABP within 30 days. If NABP does not receive a response within 30 days, NABP will assume that you do not wish to renew your DMEPOS accreditation. As such, your accreditation file will be closed and the letter of agreement (LOA) will be terminated. Please be advised that confirmation of your DMEPOS accreditation will no longer be provided to the Centers for Medicare and Medicaid Services once the LOA is terminated.

Once your file is closed you may re-apply for accreditation at a later date by submitting a new application, required documentation, and any applicable fees. A minimum of six months is typically required to complete an accreditation.

If accreditation is revoked because annual participation fees were not paid, the National Supplier Clearinghouse (NSC) will revoke the Medicare Billing Number. If a supplier does not respond to the NSC’s revocation notice and the Corrective Action Plan during the revocation process, the supplier will be suspended for one year from the Medicare program.

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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11. 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 National Supplier Clearinghouse (NSC), we encourage suppliers to seek reaccreditation for a new, three-year accreditation during the final year of their initial accreditation.

Reaccreditation typically requires a minimum of six months to complete from the point an application is submitted. NABP will contact its DMEPOS-accredited pharmacies prior to the expiration date of their current three-year accreditation to begin the reaccreditation process. Accredited suppliers are also welcome to contact NABP any time to begin the process.

NABP’s goal is to provide our DMEPOS-accredited pharmacies continuous accreditation to help avoid a gap in payment of Medicare Part B claims for products and services subject to the Centers for Medicare and Medicaid Services (CMS) Quality Standards.

The reaccreditation process is similar to the initial DMEPOS accreditation.

  • During the application stage, NABP staff will review originally submitted documentation and provide reaccreditation applicants with a Self-Assessment Evaluation Worksheet.
  • The Self-Assessment worksheet will denote if new documentation is required to bring an applicant’s file up to date. The worksheet will also help reaccreditation applicants prepare for their unannounced survey.
  • An unannounced survey of the pharmacy will be conducted to ensure that the pharmacy’s continued practice of its DMEPOS policies and procedures are in compliance with the CMS Quality Standards. Please note: If a pharmacy is not successful at survey, an additional survey with additional survey fees will be required to continue in the reaccreditation process.
  • Following resolution of any outstanding survey action items, and NABP’s verification that licenses are in good standing for the pharmacy and pharmacist-in-charge, DMEPOS staff will recommend that the NABP Accreditation Committee award the pharmacy a new, three-year DMEPOS accreditation.

To ensure continued DMEPOS accreditation compliance during a pharmacy’s initial three-year accreditation or reaccreditation, accredited pharmacies should regularly:

  • Review their DMEPOS policies and procedures and update them as needed;
  • Review DMEPOS policies and procedures and the pharmacy’s DMEPOS operations with pharmacy staff; and
  • Review the CMS Quality Standards and Medicare DMEPOS Supplier Standards in their entirety to ensure compliance.

A supplier must disclose the Medicare DMEPOS Supplier Standards to all Medicare beneficiaries. The NSC created an abbreviated, one-page version of the 30 Medicare DMEPOS Supplier Standards to help suppliers comply with this requirement. The abbreviated version must be posted within the pharmacy and given to Medicare Part B patients.

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12. 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 in writing via email at DMEPOS@nabp.pharmacy, via fax at 847/375-1795, or via a land carrier, such as United States Mail (Attn: NABP DMEPOS Accreditation, 1600 Feehanville Drive, Mount Prospect, IL 60056).

If accreditation is revoked because annual participation fees were not paid, the National Supplier Clearinghouse will revoke the Medicare Billing Number. If a supplier does not respond to the NSC’s revocation notice and the Corrective Action Plan during the revocation process, the supplier will be suspended for one year from the Medicare program.

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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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 National Supplier Clearinghouse (NSC) to seek exemption from the DMEPOS accreditation requirement.

Pharmacy exemption information can be found on the NSC websiteThe “exemption attestation statement” includes a compact fact sheet and attestation form that can be submitted to the NSC to request exemption approval.

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.”

If you have received pharmacy exemption status from the National Supplier Clearinghouse (NSC) and no longer need to be DMEPOS-accredited, please inform NABP that you have received an exemption confirmation letter and provide the date listed on the letter.

If a pharmacy informs NABP of their pharmacy exemption status and does not wish to maintain the DMEPOS accreditation, or if a pharmacy does not remit annual participation fees and compliance materials required in a timely manner to keep the accreditation current:

  • DMEPOS accreditation information for your pharmacy will no longer be provided to the Centers for Medicare and Medicaid Services.
  • 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 we request that questions regarding the pharmacy exemption attestation statement 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 ID and how do I obtain one?

The NABP e-Profile ID is the unique identifier that pharmacists, pharmacy technicians, pharmacy students, and other individuals receive when they create an NABP e-Profile account through the Association’s online registration system. The NABP e-Profile system allows individuals to easily manage their participation in NABP programs including tracking continuing pharmacy education through CPE Monitor, examination registration and score results, licensure transfer, and publication ordering. If you need any of these services, you may create your NABP e-Profile.

If you are only creating an e-Profile because your company is seeking an accreditation or verification, select CPE Monitor in the profile creation process. You will not be obligated to go past the security question screens on the profile creation page, but you will receive an e-Profile ID. However, if you are an individual that must earn CPE to satisfy license or registration requirements, you must continue on to the CPE Monitor section of the NABP e-Profile system if you want to ensure that you are fully registered in the CPE Monitor program.

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2. Is an e-Profile ID required for accreditation or verification through NABP?

Yes. NABP now requires pharmacists involved in any of its accreditation or verification programs, including those associated with accredited businesses undergoing renewal, reaccreditation, or reverification, to have an e-Profile ID. If you have not done so already, you can sign up for an NABP e-Profile account.

Additionally, NABP is in the process of assigning e-Profile IDs to facilities. While most facilities do not yet possess an e-Profile ID, soon it will be a requirement for those involved in any NABP program. If your facility has had a VPP inspection, you already have an e-Profile ID assigned to it and you may contact VPP staff via email at VPP@nabp.pharmacy for more information.

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3. How can I confirm if I (or my facility) already have an e-Profile ID?

If you are a pharmacist, a pharmacy technician, pharmacy student, or other individual, you can use the “Forgot username?” or “Forgot Password?” links on the NABP e-Profile page to recover your account log in information if you have one.

Unless your facility has been VPP inspected or has interfaced with NABP through some other NABP-sponsored program, it is unlikely it will have its own NABP e-Profile ID. If your facility has been VPP inspected, you may contact VPP@nabp.pharmacy for more information.

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