Change in Suppliers for Capped Rental DME Items

40.6.1 - Change in Suppliers for Capped Rental DME Items (Rev. 1532, Issued: 06-11-08, Effective: 07-01-08, Implementation: 07-07-08) The following rules apply when the beneficiary switches from one supplier of capped rental DME to another supplier after the beginning of each round of competitive bidding: Noncontract supplier to contract supplier In general, rental payments may not exceed a period of continuous use of longer than 13 months. However, if the beneficiary switches from a noncontract supplier to a contract supplier before the end of the 13-month rental period, a new 13-month period begins and payment is made on the basis of the single payment amounts described in section 40.6. The contract supplier that the beneficiary switches to is responsible for furnishing the item until medical necessity ends, or the 13-month period of continuous use ends, whichever is earlier. On the first day following the end of the new 13-month rental period, the contract supplier is required to transfer title of the capped rental item to the beneficiary. Once the beneficiary switches from a noncontract supplier to a contract supplier, they may not switch back to a noncontract supplier if he/she continues to maintain a permanent residence in a CBA. If, however, the beneficiary relocates out of the CBA to a non-CBA, then he/she may switch to a noncontract supplier and a new 13-month rental period does not begin. See section 40.3 for instructions for payment of grandfathered items. Contract supplier to another contract supplier If the beneficiary switches from a contract supplier to a contract supplier before the end of the 13-month rental period, a new 13-month period does not begin. This provision applies in situations where the beneficiary changes suppliers within a CBA and in situations where the beneficiary relocates and switches from a contract supplier in one CBA to contract supplier in another CBA. The contract supplier that the beneficiary switches to is responsible for furnishing the item until medical necessity ends, or the 13-month period of continuous use ends, whichever is earlier. On the first day following the end of the 13-month rental period of continuous use, the contract supplier is required to transfer title of the capped rental item to the beneficiary.