Response: Contacting Patients
Description
Collection
Title:
Response: Contacting Patients
Date:
5/3/2013
Text:
Valerie,
According to Sec. 1834. [42 U.S.C. 1395m] (a) Payme
Valerie,
According to Sec. 1834. [42 U.S.C. 1395m] (a) Payment for Durable Medical Equipment of the Social Security Act which can be found at [ <URL Redacted> <URL Redacted>
[ <URL Redacted> paragraph 17 states the following:
(17) Prohibition against unsolicited telephone contacts by suppliers.—
(A) In general.—A supplier of a covered item under this subsection may not contact an individual enrolled under this part by telephone regarding the furnishing of a covered item to the individual unless 1 of the following applies:
(i) The individual has given written permission to the supplier to make contact by telephone regarding the furnishing of a covered item.
(ii) The supplier has furnished a covered item to the individual and the supplier is contacting the individual only regarding the furnishing of such covered item.
(iii) If the contact is regarding the furnishing of a covered item other than a covered item already furnished to the individual, the supplier has furnished at least 1 covered item to the individual during the 15-month period preceding the date on which the supplier makes such contact.
(B) Prohibiting payment for items furnished subsequent to unsolicited contacts.—If a supplier knowingly contacts an individual in violation of subparagraph (A), no payment may be made under this part for any item subsequently furnished to the individual by the supplier.
(C) Exclusion from program for suppliers engaging in pattern of unsolicited contacts.—If a supplier knowingly contacts individuals in violation of subparagraph (A) to such an extent that the supplier’s conduct establishes a pattern of contacts in violation of such subparagraph, the Secretary shall exclude the supplier from participation in the programs under this Act, in accordance with the procedures set forth in subsections (c), (f), and (g) of section [ http://www.ssa.gov/OP_Home/ssact/title11/1128.htm] 1128.
Simply stated, if a phone call to a patient is regarding a covered item that we (prosthetists/orthotists) provided them in the past or if the phone call is regarding a covered item that has not previously been supplied, but we have supplied them with another covered item in the last 15 months it is okay to make an unsolicited phone call. Furthermore, if we have them sign a release form, we are legally allowed to contact them at any time after the release is signed with regards to any covered items.
A prescription will be required before dispensing any DME devices. A valid prescription requires the patient to visit their PCP and for their PCP to document the need for the covered item. However, the law clearly does not prohibit us from getting the ball rolling. By providing a covered item to a patient with a valid prescription, they become under the jurisdiction of our care and can be classified as our patients. Since we are providing devices to them based on a prescription from a physician, it is our responsibility to make sure that the covered items we are providing for our patients are fulfilling the requirements of the prescription. We can only do this by seeing our patients in our office or by contacting them on the phone. If we have not seen one of our patients in the office or spoken to them on the phone in 6 months to a year, best medical practice would stipulate that we contact them.
I hope this helps. Feel free to send this out as the response to the listserv.
Sincerely,
Chris Baschuk, MPO
Prosthetics Resident
Kootenai Prosthetics and Orthotics
1160 E Polston Ave
Post Falls, ID 83854
PH 208-457-1545
FX 208- 457-1659
<Email Address Redacted>
According to Sec. 1834. [42 U.S.C. 1395m] (a) Payme
Valerie,
According to Sec. 1834. [42 U.S.C. 1395m] (a) Payment for Durable Medical Equipment of the Social Security Act which can be found at [ <URL Redacted> <URL Redacted>
[ <URL Redacted> paragraph 17 states the following:
(17) Prohibition against unsolicited telephone contacts by suppliers.—
(A) In general.—A supplier of a covered item under this subsection may not contact an individual enrolled under this part by telephone regarding the furnishing of a covered item to the individual unless 1 of the following applies:
(i) The individual has given written permission to the supplier to make contact by telephone regarding the furnishing of a covered item.
(ii) The supplier has furnished a covered item to the individual and the supplier is contacting the individual only regarding the furnishing of such covered item.
(iii) If the contact is regarding the furnishing of a covered item other than a covered item already furnished to the individual, the supplier has furnished at least 1 covered item to the individual during the 15-month period preceding the date on which the supplier makes such contact.
(B) Prohibiting payment for items furnished subsequent to unsolicited contacts.—If a supplier knowingly contacts an individual in violation of subparagraph (A), no payment may be made under this part for any item subsequently furnished to the individual by the supplier.
(C) Exclusion from program for suppliers engaging in pattern of unsolicited contacts.—If a supplier knowingly contacts individuals in violation of subparagraph (A) to such an extent that the supplier’s conduct establishes a pattern of contacts in violation of such subparagraph, the Secretary shall exclude the supplier from participation in the programs under this Act, in accordance with the procedures set forth in subsections (c), (f), and (g) of section [ http://www.ssa.gov/OP_Home/ssact/title11/1128.htm] 1128.
Simply stated, if a phone call to a patient is regarding a covered item that we (prosthetists/orthotists) provided them in the past or if the phone call is regarding a covered item that has not previously been supplied, but we have supplied them with another covered item in the last 15 months it is okay to make an unsolicited phone call. Furthermore, if we have them sign a release form, we are legally allowed to contact them at any time after the release is signed with regards to any covered items.
A prescription will be required before dispensing any DME devices. A valid prescription requires the patient to visit their PCP and for their PCP to document the need for the covered item. However, the law clearly does not prohibit us from getting the ball rolling. By providing a covered item to a patient with a valid prescription, they become under the jurisdiction of our care and can be classified as our patients. Since we are providing devices to them based on a prescription from a physician, it is our responsibility to make sure that the covered items we are providing for our patients are fulfilling the requirements of the prescription. We can only do this by seeing our patients in our office or by contacting them on the phone. If we have not seen one of our patients in the office or spoken to them on the phone in 6 months to a year, best medical practice would stipulate that we contact them.
I hope this helps. Feel free to send this out as the response to the listserv.
Sincerely,
Chris Baschuk, MPO
Prosthetics Resident
Kootenai Prosthetics and Orthotics
1160 E Polston Ave
Post Falls, ID 83854
PH 208-457-1545
FX 208- 457-1659
<Email Address Redacted>
Citation
“Response: Contacting Patients,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/235183.
