Program_Memos / 2002 / B-02-037

Why This Topic Matters

The memo explains the operational standards used in Medicare claim review for diabetic testing supplies and clarifies what documentation and oversight may be expected from providers and suppliers. Understanding this guidance helps readers assess compliance and review processes tied to these claims.

Article Sections

1. Change Request 2133

   Introduces the memorandum and identifies the subject area addressed by CMS. It frames the scope of the medical review guidance that follows.

2. I. General Requirements

   Defines general terms used in the memorandum and provides background for how orders and refills are treated under the guidance.

3. II. Physician Requirements

   Summarizes the documentation and order-related expectations for physicians. It discusses the information that should support claims and the handling of written, faxed, electronic, and verbal orders.

4. III. Supplier Requirements

   Describes supplier responsibilities related to claim support, refill and renewal handling, supply quantity limits, documentation, and responses to review requests. It also addresses how suppliers should coordinate with physicians and avoid unsupported forms of attribution.

5. IV. DMERC Requirements

   Outlines the review authority and communication responsibilities of DMERCs. It also includes publication, effective date, implementation date, and retention timing information.