DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

CMS-1503-FC 1325
(2) Definition of Mail Order Item
We proposed to define "mail order item" in §414.402 to mean any item (for
example, diabetic testing supplies) shipped or delivered to the beneficiary's home,
regardless of the method of delivery. We also proposed to define "non-mail order item"
as any item (for example, diabetic testing supplies) that a beneficiary or caregiver
purchases at a local pharmacy or supplier storefront rather than having the item delivered
to the beneficiary’s home. For round 1 of the program, this means that beneficiaries that
do not obtain their testing supplies through mail order may purchase these items at a local
pharmacy or local storefront. Therefore, the only items excluded from the mail order
definition and mail order competition would be those that a beneficiary or caregiver
purchases at a local pharmacy or local supplier storefront and are not delivered to the
beneficiary’s home. These revised definitions of mail order item and non-mail order item
are intended to clearly identify which items is truly mail order. In addition, we believe
this definition will preserve the choice of the beneficiary to obtain replacement diabetic
supplies in person from a local pharmacy and eliminate the circumvention of the mail
order program.
As previously discussed, for Round 1 and the Round 1 Rebid of the DMEPOS
CBP, we defined mail order contract supplier in our regulations at §414.402 to mean a
contract supplier that furnishes items through the mail. We further defined mail order in
program instructions to mean "items ordered remotely (that is, by telephone, e-mail,
internet or mail) and delivered to beneficiary's residence by common carriers (for
example, U.S. Postal Service, Federal Express, United Parcel Service) and does not
include items obtained by beneficiaries from local storefronts." The intent of the Round