Article Detail - JA DME

Noridian is seeing an increase in beneficiary complaints regarding the sale of oxygen equipment.

Suppliers are reminded that Medicare will only consider an oxygen claim for payment when the equipment is rented. If a beneficiary wishes to purchase oxygen equipment, the beneficiary will be financially responsible for the entire purchase price and a claim should not be filed to Medicare.

Arrangements where the beneficiary pays up front and then the supplier files a "rental" claim until the purchase price is paid by Medicare is not an acceptable arrangement.

Suppliers may issue a voluntary Advance Beneficiary Notice (ABN) to notify the beneficiary that oxygen equipment that is purchased is statutorily non-covered. Though the beneficiary is not required to sign the voluntary ABN, we encourage suppliers to point out Option 2 to help the beneficiary understand their financial responsibility and that a claim will not be filed. In this situation, the ABN is used to provide notification of financial liability for items that Medicare never covers.