The following was provided by AOA for its members’ information:
If an OD wishes to provide eyeglasses to cataract patients under Medicare, you must pay a DMEPOS registration fee (currently $523) every 3 years. But, you do not need to pay until you receive a (yellow) envelope from your Medicare carrier to revalidate and renew your DMEPOS enrollment.
If an OD does NOT provide eyeglasses to cataract patients under Medicare, you do NOT pay the DMEPOS registration fee.
On the separate DMEPOS Surety Bond, most ODs do NOT pay this unless you provide eyeglasses to those who are NOT patients and you provide no sort of exam of the patient.
Optometrists who wish to provide eyeglasses for cataract patients under Medicare are subject to a new durable medical equipment prosthetics, orthotics and supplies (DMEPOS) registration fee every three years, according to the AOA Advocacy Group. The fee was put in place in March 2011 over the objections of AOA and other physician organizations when the Centers for Medicare & Medicaid Services (CMS) decided to treat all DMEPOS suppliers as institutional fraud risks.
Under a government initiative to screen out unscrupulous providers, all physicians who are now enrolled as health care practitioners or suppliers under Medicare will be required to re-enroll by March, 2015. Optometrists should watch for letters to revalidate their Medicare enrollment, which verifies their enrollment records in the government health plan’s Provider Enrollment, Chain and Ownership System (PECOS).
Optometrists and other health care physicians who wish to provide only professional services are NOT subject to any Medicare registration fees. However, those who provide health care products, including eyeglasses, are subject to a new $500+ fee ($523 this year, indexed to increase annually with inflation) as well as stringent new screening requirements including site visits by inspectors. The fee is 'per supplier,' which in most ODs' offices would be the clinic's (optical) dispensary and not individual doctors. As an example, a practice with two locations, each with a dispensary, would then pay two fees. One location practice with a dispensary would pay once.
The Medicare DMEPOS registration fee is distinct from the health plan’s DMEPOS provider surely bond requirement, from which optometrists have been exempted unless they provide eyeglasses to the public without any sort of examination of the patient, and separate from the DMEPOS accreditation requirement, until the CMS decides to implement supplier standards for physicians.
The AOA Advocacy Group has been lobbying to win exemption for optometrists from the DMEPOS registration fee as well. However, at this time, the registration fee remains applicable to eyewear providers and other physicians who furnish DMEPOS to their patients, AOA Advocacy Group staff note.
Many optometrists have been receiving notifications to reenroll in Medicare over recent weeks, the AOA Advocacy Group reports.
For additional information, see "HHS anti-fraud program to mean new scrutiny, fees for physicians" on the AOA News blog or the Medicare Learning Network (MLN) article "Further Details on the Revalidation of Provider Enrollment Information."