Rascal R600 Scooter Owner’
EMC P
34
Application Cer
The supplier must meet and must certify in its application for billing privileges that it meets and will continue to meet the following standards:
1. Operates its business and furnishes Medicare-covered items in compliance with all Federal and State licensure and regulatory requirements;
2. Has not made, or caused to be made, any false statement or misrepresentation of a material fact on its application for billing privileges. (The
supplier must provide complete and accurate information in response to questions on its application for billing privileges. The supplier must
report to HCF
3. Must have the application for billing privileges signed by an individual whose signature binds a supplier;
4. Fills orders, fabricates, or fits items from its own inventory or by contracting with other companies for the purchase of items necessary to fill
the order
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 Government Executive Branch procurement or non-procurement program or activity;
5. Advises beneficiaries that they may either rent or purchase inexpensive or routinely pur
option for capped rental durable medical equipment, as defined in §414.220(a) of this subchapter
documentation that it has provided beneficiaries with this information, in the form of copies of letters, logs, or signed notices);
6. Honors all warranties expressed or implied under applicable State law
the repair or replacement of Medicare covered items or for services covered under warrantysed and rented
items, including capped rental items, as described in §414.229 of this subchapterumentation
that it has provided beneficiaries with information about Medicare covered items covered under warranty
or signed notices;
7. Maintains a physical facility on an appropriate site. The physical facility must contain space for storing business records including the
supplier’mmer
mailbox is not considered a physical facility
8. Permits HCFA, or its agents to conduct on-site inspections to ascer
location must be accessible during reasonable business hours to beneficiaries and to HCF
of operation.
9. Maintains a primary business telephone listing the name of the business locally or toll-free for beneficiaries. The supplier must furnish
information to beneficiaries at the time of delivery of items on how the beneficiary can contact the supplier by telephone. The exclusive use of
a beeper number
telephone for the purpose of this regulation;
10. Has a comprehensive liability insurance policy in the amount of at least $300,000 that covers both the supplier’
customers and employees of the supplier
liability and completed operations. Failure to maintain required insurance at all times will result in revocation of the supplier’
retroactive to the date the insurance lapsed;
11. Must agree not to contact a beneficiary by telephone when supplying a Medicare-covered item unless one of the following applies:
(i) The individual has given written permission to the supplier to contact them by telephone concerning the furnishing of Medicare-covered
item that is to be rented or purchased.
(ii) The supplier has furnished a Medicare-covered item to the individual and the supplier is contacting the individual to coordinate the
delivery of the item.
(iii) If the contact concerns the furnishing of a Medicare-covered item other than a covered item already furnished to the individual, the
supplier has furnished at least one covered item to the individual during the 15-month period preceding the date on which the supplier
makes such contact
12. Must be responsible for the delivery of Medicare covered items to beneficiaries and maintain proof of delivery. The supplier must document
that it or another qualified party has at an appropriate time, provided beneficiaries with necessary information and instructions to use
Medicare-covered items safely and effectively;
13. Must answer questions and respond to complaints a beneficiary has about the Medicare covered item that was sold or rented. A supplier must
refer beneficiaries with Medicare questions to the appropriate carrier beneficiaries
regarding complaints or questions;
14. Must maintain and replace at no charge or repair directlyred items it has
rented to beneficiaries. The item must function as required and intended after being repaired or replaced;
15. Must accept returns from beneficiaries 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);
16. Must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item;
17. Must comply with the disclosure provisions in §420.206 of this subchapter;
18. Must not convey or reassign a supplier number;
19. Must have a complaint resolution protocol to address beneficiary complaints that relate to supplier standards in paragraph (c) of this section
and keep written complaints, related correspondence and any notes of actions taken in response to written and oral complaints. Failure to
maintain such information may be considered evidence that supplier standards have not been met. (This information must be kept at its
physical facility and made available to HCF
20. Must maintain the following information on all written and oral beneficiary complaints, including telephone complaints, it receives
(i) The name, address, telephone number
(ii) A summar
to resolve the complaint.
(iii) If an investigation was not conducted, the name of the person making the decision and the reason for the decision.
21. Provides to HCF
