SUBJECT:

MediSource Corp.,

Petitioner,

Palmetto GBA and The National Supplier Clearinghouse.

DECISION

I reverse the determination of the Carrier Hearing Officer (Hearing Officer) to deny reinstatement of the supplier number assigned to MediSource Corporation (Petitioner), Supplier Tax ID No. 65-0619107. I find that while the Hearing Officer's decision affirming the National Supplier Clearinghouse (NSC or Respondent) was proper at the time it was issued, Petitioner has corrected all deficiencies and is entitled to receive a Medicare supplier enrollment number (supplier number) ⁽¹⁾ effective April 6, 2005.

I. Background

By a letter dated October 12, 2004, the NSC notified Petitioner that its Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) billing number would be revoked effective 15 days from the postmarked date of the letter because Petitioner failed to meet supplier standards 1, 8, and 10 of 42 C.F.R. � 424.57(c). By a letter dated October 21, 2004, Petitioner appealed the revocation and requested a hearing by a Hearing Officer. On December 10, 2004, the Hearing Officer conducted a telephone hearing. By a decision dated December 15, 2004 (December decision), the Hearing Officer decided that Petitioner was in compliance with standards 1 and 10, but remained out of compliance with supplier standard 8, in part, because a site inspection had not been completed; therefore, Petitioner was not entitled to have its supplier number reinstated. Subsequently, NSC completed a site inspection a day later on December 16, 2004. By a letter dated February 4, 2005, Petitioner submitted the Revised Enrollment Application to the CMS Official, Office of Hearings, Baltimore, Maryland with a letter requesting a "follow-up hearing to correct the one remaining deficiency . . . ." CMS forwarded Petitioner's request and application to the Civil Remedies Division and the case was docketed as a timely appeal of the NSC denial. By letter dated February 17, 2005, NSC filed its response to the notice of the request for hearing. Rather than address standard 8, which dealt with accessibility to conduct a site inspection, NSC explained that standard 7 was now at issue: specifically NSC raised an issue dealing with Petitioner's physical facility. On April 6, 2005, a second site inspection was completed.

II. Issue, findings of fact and conclusions of law

A. Issue

The issue in this case is whether Petitioner is entitled to a supplier number.

B. Findings of fact and conclusions of law

Petitioner has corrected all outstanding deficiencies, is in compliance with all 21 Medicare supplier standards, and is entitled to a Medicare supplier enrollment number.

To qualify for a DMEPOS supplier number, a supplier must meet certain standards. Those standards are set forth at 42 C.F.R. � 424.57(c)(1) through (21).

Standard 7 of 42 C.F.R. � 424.57(c) states:

Maintains a physical facility on an appropriate site. The physical facility must contain space for storing business records including the supplier's delivery, maintenance, and beneficiary communication records. For purposes of this standard, a post office box or commercial mailbox is not considered a physical facility. In the case of a multi-state supplier, records may be maintained at a centralized location;

Supplier standard 8 of 42 C.F.R. � 424.57(c) states:

Permits CMS, or its agents to conduct on-site inspections to ascertain supplier compliance with the requirements of this section. The supplier location must be accessible during reasonable business hours to beneficiaries and to CMS, and must maintain a visible sign and posted hours of operation;

On appeal here, NSC determined that standard 8 was no longer at issue, since it had performed a site inspection on December 16, 2004. As a result of that site inspection, the NSC determined that standard 7 was now at issue. The NSC explained:

The inspection revealed that the supplier is sharing space with a pharmacy that has an active supplier number. The inspections also showed that Medisource has a room inside the pharmacy. The room does not have a separate suite for Medisource, the licenses and insurance are also for the same address as the pharmacy. For this reason, the NSC feels that the supplier is not in compliance with standard 7.

NSC February 17, 2005 response. The standard 8 issue, which, among other things, addresses the accessibility to conduct a site inspection became moot as the result of the December site inspection. Thus, the only issue before me in this matter relates to standard 7.

On February 4, 2005, Petitioner submitted a Revised Enrollment Application in which they indicated that the supplier's physical location had moved to a new location at 7025 Beracasa Way, Suite 102B, Boca Raton, Florida 33433. Having received information regarding Petitioner's new address, a new site inspection was ordered and completed on April 6, 2005.

Subsequently, on April 21, 2005, NSC notified my office electronically that in order to approve the application, it needed the application with an original signature. ⁽²⁾ At my direction, the original Revised Enrollment Application was shipped by Federal Express to NSC on April 27, 2005. By electronic notification on May 17, 2005 ⁽³⁾, NSC stated, in relevant part:

I have received the change of address with the original signature from the supplier. In reviewing the information submitted and the site inspection that was completed on April 6, 2005, the supplier is now in compliance with all 21 standards.

I find that Petitioner is in compliance with all 21 Medicare supplier standards, and is entitled to a Medicare supplier enrollment number. Having previously submitted the Revised Enrollment Application with original signature, Petitioner is deemed to have met all requirements as of April 6, 2005, the date of the completed site inspection.

Marion T. Silva

Chief Administrative Law Judge

1. NSC submitted the Hearing Officer's Administrative Record, which I admit as Respondent's Exhibit (R. Ex.) 1, 1-116. Petitioner submitted its revised Medicare Federal Health Care Provider/Supplier Enrollment Application with original signature (Revised Enrollment Application), which I admit as Petitioner's Exhibit (P. Ex.) 1.

2. Electronic printout, dated April 21, 2005, which I admit as R. Ex. 2.

3. Electronic printout, dated May 17, 2005, which I admit as R. Ex. 3.