DMEPOS, Medicaid, and CHAP Accreditation Standards and Inspection Compliance

What does DMEPOS stand for?

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies

Which of the following is a primary purpose of the DMEPOS Quality Standards for Power Mobility?

To ensure the provision of high-quality power mobility devices

What is required by DMEPOS standards regarding documentation for power mobility equipment?

Documentation must include a physician's order and a face-to-face examination

According to DMEPOS standards, who is responsible for the delivery of the power mobility device?

The supplier

Which of the following best describes a key component of quality standards for power mobility devices?

Consistent device performance and safety

Under the DMEPOS Quality Standards, what is required for power mobility providers regarding staffing training?

All staff involved must have proper training in power mobility technology and equipment

DMEPOS standards require supplies to provide which of the following services post-delivery?

Device maintenance and repairs

Medicaid's primary objective for quality standards in power mobility is to:

Ensure beneficiaries have access to medically necessary power mobility devices

What is the requirement for Medicaid coverage of power mobility devices?

The patient must have a prescription from a primary care physician

According to Medicaid guidelines, what must be documented in the patient's medical record when requesting a power mobility device?

A face-to-face examination and written order from a physician

Medicaid's policy for power mobility equipment focuses on:

Quality and clinical necessity

What is required to quality for Medicaid reimbursement for a power mobility device?

A physician's recommendation based on the patient's medical necessity

What are Medicaid's guidelines for reassessing the patient's need for a power mobility device?

Regular reassessments based on the patient's condition or status are necessart

Medicaid coverage for power mobility devices does not include:

Non-medically necessary upgrades

What is the primary purpose of the CHAP Accreditation Standards?

To ensure healthcare organizations meet high quality standards

Which of the following must healthcare organizations meet to achieve CHAP accreditation?

Compliance with patient safety and quality of care standards

Hoe often is CHAP accreditation required to be renewed?

Every 2 years

Which of the following is an essential component of CHAP accreditation for power mobility providers?

Comprehensive patient education and training

CHAP standards require power mobility providers to demonstrate:

Compliance with medicare and Medicaid guidelines

According to CHAP standards, what is the role of quality assurance programs for power mobility providers?

Improving patient satisfaction and clinical outcomes

CHAP standards mandate that power mobility providers:

Maintain accurate patient records and documentation

In the context of CHAP accreditation, what does "patient-centered care" mear?

Ensuring that care is tailored to the individual's specific needs

Under CHAP standards, which of the following is a requirement for staff involved int he provision of power mobility devices?

Staff must be licensed or certified as appropriate for their role

What documentation is required to maintain CHAP accreditation for power mobility providers?

Comprehensive patient assessments and care plans

CHAP accreditation for power mobility services includes the assessment of:

• Device selection and delivery practices
• Customer service procedures
• Compliance with safety and regulatory standards

Which government agency oversees the DMEPOS quality standards in the United States?

Centers for Medicare and Medicaid Services (CMS)

What does CHAP stand for?

Community Health Accreditation Program

What is one key factor that Medicaid considers when approving a power mobility device?

Patient's medical necessity for mobility assistance

Which of the following is part of Medicaid's documentation requirement for power mobility devices?

• A face-to-face examination by a physician
• The patient's diagnosis and prognosis

CHAP's standards ensure that healthcare providers maintain:

A focus on quality care and patient satisfaction

Is your DME company properly licensed and registered in accordance with state and federal regulations?

Yes, this process is managed by our Compliance Department

Can you provide documentation that shows the company complies with all applicable local, state, and federal laws related to DME provision?

Yes, it is reflected in our Compliance Program Policy and Code of Conduct

How do you ensure that the DME products you provide are safe, functional, and of the appropriate quality?

Our commitment to quality is established during the engagement process with our manufacturer and verified by inventory specialists

Do you have procedures in place to verify the identity of the beneficiary and confirm the appropriate need for the DME?

Yes, through patient ID, member card, P-Verify, and delivery verification

How do you manage the billing process to ensure accurate submission of claims to Medicare, medicaid, and other payers?

Based on ID verification, double-checking delivery documentation, Prior Authorization (PA), and diagnosis

Do you maintain records of the beneficiaries you serve, including orders, documentation of need, and delivery details?

Yes, all records are maintained in our electronic business record system

What is you procedure for verifying a physician's order before providing any equipment?

Verify the date of signature, Prior Authorization (PA) form, Certification of Medical Necessity (CMN), and PECOS (Provider Enrollment, Chain, and Ownership. System) or OPR (Ordering, Prescribing, or Referring provider)

Can you demonstrate how you verify medical necessity for DME items you provide?

We use a Prior Authorization checklist and interal review per guidelines

How do you ensure that the equipment provided meets the patient's specific medical needs?

We rely on referring providers, Physical Therapists, occupational therapists, and Assistive Technology Professionals (ATPs) to determine the patient's needs

Are you able to provide proof that the equipment provided was delivered to the correct beneficiary?

Yes, through proof of delivery and Home Assessment records

What steps do you take to ensure your inventory of DME is maintained properly and free from defects?

We follow the Operational Verification Procedure (OVP) to ensure equipment is free of defects

How are repairs, maintenance, and servicing of medical equipment managed for the products you provide to patients?

Tracked through our electronic system, Brightree Maintenance log, and customer service requests

Do you have a process for managing recalls of equipment? And how do you inform beneficiaries if their equipment is affected?

Yes, we notify affected patients via a letter and compile a report

Do you provide training or guidance to patients with the proper use and maintenance of the equipment they receive?

Yes, every patient receives guidance at delivery, with acknowledgement of receipt

Can you provide documentation for your supplier's policies and procedures regarding compliance with Medicare, Medicaid, and other regulations?

Yes, it's included in our Policy and Procedure Manual and Code of Conduct

Do you have a policy for preventing fraud, waste, and abuse, and can you demonstrate adherence to this policy?

Yes, through our Compliance Program Policy, FWA education, and mandatory training

Can you provide copies of audits, inspections, or assessments conducted by regulatory authorities or accrediting bodies?

Yes, we maintain copies of all audits and assessments

What steps do you take to ensure that your staff are trained and comply with all relevant healthcare regulations?

Mandatory training with 100% completion and monthly audits

How do you ensure that the physician's orders are current and specific to the beneficiary's medical needs?

Ensure face-to-face validation is within 6 months and delivery occurs within the PA approval period

Can you provide examples of how you coordinate healthcare professionals (e.g., physicians, clinicians) when providing equipment?

Face-to-face validation, Physical Therapist/Occupational Therapist (PT/OT) evaluations, Assistive Technology Professional (ATP) review, and referring provider agreement