Prosthetics, medical equipment, and orthotic suppliers’ bonds have a couple of other names such as Medicare Bond and DMEPOS medical bonds. This medicare bond requirement is a minimum of $50k for most companies, not sole proprietorships, and is there to help reduce Medicare costs.
However, this amount could go up substantially should that applicant have a shady type background which could be a loss or suspension of accreditations, felony convictions, lost medicare billing privileges in the past, or a suspended license.
Medicaid and Medicare are some of the largest programs out there that have over 60 million participants. It is health care for those with disabilities or who are low income. These programs are funded by both the state and federal governments and have strict rules. With so many people using this sort of insurance, it can be prone to fraud. There are steps put in place to ensure that the billing practices are in check. Billing practices should be transparent, accurate, and consistent. However, they take it one step further for those providers that provide prosthetics, durable medical equipment, and orthotics (DMEPOS).
There are state and federal levels of medical bonds needed.
Because the DMEPOS require more protection, providers are to get a surety bond from other places. There are both medicare surety medical bonds and state Medicaid surety bonds. The medicare bond requirement is different than that of Medicaid. These are things that are considered DMEPOS:
If you provide this equipment you will need to get a surety medical bond. Before you can become a provider of these things you must first become accredited. To become a supplier you must also follow the standards that are set up by CMS. These will include the types of os services offered, provider location, surety bonding requirements, and information disclosure.
Different rules for each state.
There are several agencies that help providers obtain their accreditation. Medicare surety bonds are federally regulated and are the same for every state. However, Medicaid surety medical bonds are quite different from state to state. It would be best to get an attorney if you are planning on being a provider and need a further in-depth understanding of what is required from you.
Medicaid is state-issued and thus, it is at the state level that the rules apply. While the Medicare bond requirement is at the national level. Every state requires this, even if they have very different rules. So, it is important that providers fully understand what is expected of them.
These surety bonds help reduce Medicaid and Medicare fraud and save taxpayers money. Some providers are exempt from needed Medicare surety medical bonds. These are government-owner providers, sole proprietorships, and some other physical therapists and physicians that provide these things as a part of their treatment plan.
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The providers’ credit score is another factor in determining how much the surety bond should be for. Medicare and Medicaid process 1000s of claims a day and can be complicated to work with. However, there are companies that can assist providers with getting a surety bond.
