A new Medicare Learning Network (MLN) article reminds DME suppliers and complex rehab technology providers of new limits on filing Medicare claims.
The Affordable Care Act, which passed on March 23, 2010, significantly reduced the window for suppliers to file claims.
In essence, the Affordable Care Act required DME claims to be filed within 12 months after the equipment or services were provided. That policy went into effect on Jan. 1, 2010.
In addition to stating the new regulations for submitting claims, the MLN article also lists exceptions to the 12-month rule. Exceptions include administrative errors by a Medicare contractor or agent of the department; retroactive Medicare entitlement, in which a beneficiary was supposedly ineligible for Medicare benefits at the time of service, but is later found to be entitled to those benefits; a retroactive Medicare entitlement involving state Medicaid agencies; or a retroactive disenrollment from a Medicare Advantage plan.
To download the article, go to cms.gov/MLNMattersArticles/Downloads/MM7270.pdf.