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Change in Medicare [replacement supplies]
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Snoozy18 Offline

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Posts: 1
Joined: Aug 2013

Machine: PR System One
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: Sytem One
CPAP Pressure: 9.0
CPAP Software: Other Software

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Sex: Female

Post: #31
RE: Change in Medicare [replacement supplies]
I get a "robocall" from my DME every three months now, asking "Do you need a new mask because your old one is not fitting properly or stained? Do you need a new hose because it has mold or milder in it?" and so forth. So I technically am ordering the supplies and giving a reason prompted by ms. robot.
This suggests to me a new requirement to have justification for the order.
08-04-2013 05:03 PM
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knightlite Offline

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Posts: 24
Joined: Jul 2013

Machine: respronics ds560
Mask Type: Full face mask
Mask Make & Model: mirage quattro
Humidifier: resperonics
CPAP Pressure: 10-14.5
CPAP Software: SleepyHead

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Sex: Undisclosed

Post: #32
RE: Change in Medicare [replacement supplies]
My dme requires me to fill out paper work indicating that I'm requesting supplies and Why! I believe they are defending themselves from medicare audits .
I have to check or say the equipment is defective and is leaking to get hoses and masks or mask parts.
Even cushions for the mask, I'm told that time is not enough of a reason ,it must be defective ,cracked ,torn , leaking ,not functional .
My DME has always been tight with supplies , but he is owner operator . I know they are nervous about the new competitive bidding which does not affect us yet as we are in the woods.
I think their major income is oxygen supplies , as we are a heavily retired area.
They usually have the paperwork with them when they drop it off, and if I miss them they leave a return envelope with the paper work inside. So they are very serious about documentation .
I really don't have a problem with that. But I have bought some of my own masks and supplies outright from private parties. Some from online suppliers.
08-04-2013 06:59 PM
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grumpycat Offline

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Posts: 27
Joined: Mar 2013

Machine: resmed S9autoset
Mask Type: Nasal mask
Mask Make & Model: wisp
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CPAP Pressure: 5-20
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: new jersey, u.s.a.

Post: #33
RE: Change in Medicare [replacement supplies]
Ok, here are the results of a little bit of internet research:

In June 2013, the Federal Office of the Inspector General for the Department of Health and Human Services issued a report and recommendations regarding the replacement schedule for CPAP supplies under Medicare.

This report suggested that the Centers for Medicare & Medicaid Services (CMS) revise its replacement schedules for CPAP supplies because the current replacement schedule allows overuse. CMS disagreed with this finding, so it looks like everything remains the same.

The Inspector General's report does contain what appears to be the current replacement schedule on page 4 of the report.

Hope this helps.
08-04-2013 10:06 PM
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