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In the US a certificate of medical necessity is a document required by Centers for Medicare and Medicaid Services to substantiate in detail the medical necessity of an item of durable medical equipment or a service to a Medicare beneficiary. [1]
It is often referred to as "durable" medical equipment (DME) as it is intended to withstand repeated use by non-professionals or the patient, and is appropriate for use in the home. Medical supplies of an expendable nature, such as bandages, rubber gloves and irrigating kits are not considered by Medicare to be DME.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
The DME scheme was reminiscent of Medicare fraud in South Florida in the 1990s before it spread to other areas of medicine, such as physical therapy, diabetic injections and mental health services.
Medicare recipients can now get up to eight free COVID-19 tests per month from participating pharmacies and healthcare providers, the Biden administration announced on Monday. See: You May Be ...
In the United States, durable medical equipment has a distinct meaning within government healthcare assistance programs including Medicare and the Social Security Administration. For example, in order for equipment to match Medicare's definition of DME, it must match the following criteria: Durable (can withstand repeated use)
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Medicare Prescription Drug, Improvement, and Modernization Act; Long title: An act to amend title XVIII of the Social Security Act to provide for a voluntary prescription drug benefit under the medicare program and to strengthen and improve the medicare program, and for other purposes.