• A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements

• A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.

• An authorized individual (one whose signature is binding) must sign the application for billing privileges.

• A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or from any other Federal procurement or non-procurement programs.

• A supplier must advice beneficiaries that may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.

• A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.

• A supplier must maintain a physical facility on an appropriate site.

• A supplier must permit CMS (formerly HCFA), or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.

• A supplier must maintain a primary business telephone listed under the name of the business in a local directory ora toll free number available through directory assistance. The exclusive use of a beeper, answering machine or cell phone is prohibited.

• A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and all employees of the supplier. If the supplier manufactures its own items, this insurance must cover product liability and completed operations.

• A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from calling beneficiaries in order to solicit new business.

• A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.

• A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contracts.

• A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company. Medicare-covered items it has rented to its beneficiaries.

• A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.

• A supplier must disclose to the government any person having ownership, financial or control interest in the supplier.

• A supplier must not convey or reassign a supplier number; i.e the supplier must may not sell or allow another entity to use its Medicare billing number.

• A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards. A record of these complaints must be maintained at the physical facility.

• Complaint records must include: the name, address, telephone number and health insurance claim number of the beneficiary, a summary of the complaint, and any actions taken to resolve it.

• A supplier must agree to furnish CMS any information required by the Medicare stature and implementing regulations.

• All suppliers must be accredited by a CMS-approved accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services, for which the supplier is accredited in order for the supplier to receive payment of those specific products and services (except for certain pharmaceuticals).

• All suppliers must notify their accreditation organizations when a new DMEPOS location is opened.

• All supplier locations, whether owned or or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare.

• All suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation.

• All DMEPOS suppliers must obtain a surety bond in order to receive and retain a supplier billing number.

• A supplier must obtain oxygen from a State/licensed oxygen supplier

• A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C.F.R 424.516(f)

• DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.

• DMEPOS suppliers must remain open to the public for a minimum of thirty hours per week with certain exceptions.

The Patients’ Bill Of Rights and responsibilities has three goals: to strengthen consumer confidence that the healthcare system is fair and responsive to customer needs; to reaffirm the importance of a strong relationship between patients and their healthcare providers; and to reaffirm the critical role customers play in safe guarding their own health.

• The Right to Information. The patients have the right to receive accurate, easily understood information to assist them in making informed decisions about their health plans, facilities and professionals.

• The Right to Choose. Patients have the right to a choice of healthcare providers that is sufficient to a share access to appropriate high-quality healthcare including giving women access to qualified specialists such as obstetrician-gynecologist and giving patients with serious medical conditions and chronic conditions access to specialists.

• Access to Emergency Services. Patients have the right to access emergency health services when and where the need arises. Health plans should provide payment when a patient presents himself/herself to any emergency department with acute systems of sufficient severity “Including severe pain” that a “prudent layperson” could reasonably expect the absence of medical attention to result in placing that customers health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

• Being a Full Partner in Healthcare Decisions. Patients have the right to fully participate in all decisions related to their healthcare. Consumers who are unable to fully participate in treatment decisions have the right to be represented by parents, guardians, family members, or other conservators. Additionally, provider contract should not contain any so-called “gag clauses” that restrict health professionals’ ability to discuss and advise patients on medically necessary treatment options.

• Care Without Discrimination. Patients have the right to considerate, respectful care from all members of the healthcare industry at all times and under all circumstances. Patients must not be discriminated against in the marketing or enrollment or in the provision of healthcare services, consistent with the benefits covered in their policy and/or as required by law based on race, ethnicity, national origin, religion, sex, age, current or anticipated mental or physical disability, sexual orientation, genetic information, or source of payment.

• The Right to Privacy. Patients have the right to communicate with healthcare providers in confidence and to have confidentiality of their individually/identifiable healthcare information protected. Patients have the right to review and copy their own medical records and request amendments to their records.

• The Right to Speedy Complaint Resolution. Patients have the right to affair and efficient process for resolving differences with their health plans, healthcare providers, and the institutions that serve them, including a rigorous system of internal review and an independent system of external review.

• Patient Responsibilities. In a healthcare system that affords patients rights and protections, patients must also take greater responsibility for maintaining good health. Further, we ask that you provide, to the best of your ability, accurate and complete information about your present condition, past illnesses, hospitalizations, medication, and other matters related to your health or your child’s, including information about home and/or work that may impact your ability to follow the proposed treatment; follow the treatment plan developed with your provider. You should express any concerns about your ability to comply with the proposed course of treatment. You are responsible for the outcomes if you refuse treatment or do not follow your care provider’s instructions; be considerate of other patients and staff and their property. Abusive, threatening, or inappropriate languages or behavior will not be tolerated; keep appointments or call us when you are unable to do so; be honest about your financial needs so we can connect you to appropriate resources; give us any healthcare proxy or other legal document that may affect your decision making ability or care, such as a power of attorney or court order; and notify if you object to students or researches participating in your care.

Effect Date: April 14th, 2003
This notice describes how medical information about you may be used or disclosed and how you can get access to information. Please review it carefully.

Capital Medical Corporation (CMC) Legal Duty. CMC is required by law to protect the privacy of your personal health information, provide this notice about our information practices and follow the information practices that are described herein.

Uses and Disclosures of Health Information. CMC uses your personal health information primarily for treatment, obtaining payment for treatment, conducting internal administrative activities and evaluating the quality of care that we provide. For example, CMC may use your personal health information to contact you to provide appointment reminders, or information about treatment alternatives or other health related benefits that could be of interest to you. CMC may also use or disclose your personal health information without prior authorization for public health purposes, for auditing purposes, for research studies and for emergencies. We also provide information when required by law. In any other situation, CMC’s policy is to obtain your written authorization before disclosing your personal health information. If you provide us with a written authorization to release your information for any reason, you may later revoke that authorization to stop future disclosures at any time. CMC may change its policy at any time.

Patient’s Individual Rights. You have the right to review or obtain a copy of your personal health information at any time. You have the right to request that we correct any inaccurate or incomplete information in your records. You also have the right to request a list of instances where we have disclosed your personal health information for reasons other than treatment, payment or other related administrative purposes except when specifically authorized by you, when required by law or an emergency circumstances. CMS will consider all requests on a case by case basis, but the practice is not legally required to accept them.

Concerns and Complaints. If you’re concerned that CMC may of violated your privacy rights, or if you disagree with any decisions we have made regarding access or disclosure of your personal health information, or if you have a complaint, please contact our practice manager at CMS with above contact information. You may also send a written complaint to the US Department of Health and Human Services at 200 Independence Ave., S.W. Washington, DC 20201. To report abuse, neglect, or exploitation please call toll-free 1 (800) 962-2873. To report complaints regarding equipment and services, contact the AHCA information center toll-free 1 (888)-419-3456.

Effective Date: January 1st, 2007
Last Date Revised: December 5th, 2008

Policy

When equipment is delivered and setup, the patient’s/client’s home will be assessed for potential hazards, and corrective measures will be suggested. Findings and recommendations will be documented in the patient/client record.

Procedures

Following our general home safety issues that may be communicated to the patient/client as needed.

Equipment Operation
• Follow the provided instructions for operating the equipment
• Never reset, bypass, or cover alarms, and be sure alarms are not covered up when the device is carried in a bag.

Fire Safety
• Install smoke detecters in the home. Test them monthly and change the batteries twice a year.
• Identify doors, windows, or alternative exits that may be used in a fire.
• Post the fire departments phone number by each phone.
• Purchase a fire extinguisher and insure that every family member knows how to use it.
• Be careful with smoking materials.
• Never use oxygen in the presence of smoking materials or open flames.

Electric
• Use approved surge protectors rather than extension chords when possible.
• Do not stretch electrical cords across walkways as they may present a tripping hazard.
• Arrange furniture so that outlets may be used without an extension cord.
• Do not set furniture on top of electrical cords. The cord could become damaged and create potential fire and shock hazards.
• Do not run electrical cords under carpeting as it may cause a fire.
• Do not overload outlets.
• Use a lightbulb of the correct type and wattage to avoid overheating and potential fire hazards.
• Keep heaters away from passageways and flammable items (e.g., curtains)

Lighting
• Make sure stairways are clearly lit from top to bottom so that each step is visible.
• Install light switches at the top and bottom of the stairs.
• Keep a flashlight close at hands.