Wait, What? Palmetto GBA and Novitas Solutions Now Administer Medicare DMEPOS

Maybe it is just us hardcopy application diehards, but this news hit us hard - The Centers for Medicare & Medicaid Services ("CMS") ended the National Supplier Clearinghouse ("NSC") and split the durable medical equipment, prosthetics, orthotics, and supplies ("DMEPOS") contract, effective November 7, 2022. Instead of NSC, we now have National Provider Enrollment ("NPE") West and NPE East.

NPE West

If you're located west of the Mississippi River, you won't experience a difference - Palmetto GBA will handle it. You call the same customer service number, use the same mailing addresses, and all web tools will remain the same.

States: Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming, American Samoa, Guam, Northern Mariana Islands.

NPE East

If you're located east of the Mississippi River, you are dealing with Novitas Solutions - the "newbie." Okay, maybe that isn't a fair characterization - Novitas is no stranger to program administration, as it has Part A and Part B contracts. But, DMEPOS is new for Novitas.

States: Alabama, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia, Wisconsin, District of Columbia, Puerto Rico, US Virgin Islands.

Bottom line - substantively, this isn’t earth shattering - for instance, DMEPOS supplier standards are the same. You just need to brace for the usual hiccups when there is a change in contractors.

For questions about the effect of NPE East and NPE West, please contact your Quarles & Brady attorney or:

• Anne O'Brien: (312) 715-5259 / anne.o'brien@quarles.com
• Elizabeth Gebarski: (414) 277-5303 / elizabeth.gebarski@quarles.com
• Christopher Guthrie: (608) 283-2472 / christopher.guthrie@quarles.com