Use of inactive or “retired” CMNs will not be recognized by Cigna for either medical necessity purposes or as a substitute for a written order

August 7, 2009

Suppliers often create forms to facilitate gathering medical necessity information and ordering durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), calling them “Certificates of Medical Necessity.” While supplier-created forms are generally not prohibited, suppliers must also recognize that a Certificate of Medical Necessity (CMN) is a specific Medicare term that describes an Office of Management and Budget (OMB)-approved form created by the Centers for Medicare and Medicaid Services (CMS). CMS is required to review and update the forms on a periodic basis and receive approval from the OMB in order to continue their use.

Only OMB-approved, active CMNs that are in use for the date of service on the claim under consideration for reimbursement will be recognized by CIGNA Government Services (CGS) in support of medical need or, when completed properly, as a substitute for a written order. Use of inactive or “retired” CMNs will not be recognized by CGS for either medical necessity purposes or as a substitute for a written order.

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CMS Sets Timeline for Round 1 Rebid

August 3, 2009

In a list-serv message this afternoon, the Centers for Medicare & Medicaid Services announced the following timeline for the Round 1 rebid of Medicare’s DMEPOS competitive bidding program:

8/3/2009
The Centers for Medicare & Medicaid Services (CMS) announces timeline/schedule of education events, begins bidder education campaign

8/17/2009
Registration for user IDs and passwords begins.

9/30/2009
Last day for DMEPOS suppliers to get accredited

10/2/2009
DMEPOS supplier surety bond deadline

10/21/2009
CMS opens 60-day bid window for Round 1 Rebid

11/21/2009
Covered Document Review Date for bidders to submit financial documents

12/21/2009
60-day bid window closes

June 2010
CMS announces single payment amounts, begins contracting process

September 2010
CMS announces contract suppliers, begins contract supplier education campaign

Early Fall 2010
CMS begins supplier, referral agent, and beneficiary education campaign

1/1/2011
New program begins!