Organ Procurement Organizations (OPOs)
An OPO is an organization that performs or coordinates the procurement, preservation, and transport of organs, and maintains a system for locating prospective recipients for available organs. There are three general steps involved in becoming a Medicare OPO: enrollment, certification and designation.
Certification means that CMS has determined that an OPO meets the requirements for certification at 42 CFR §486.303. It does not mean, however, that the OPO can begin billing for services. CMS must first assign (or “designate”) a geographic service area to the OPO. (The provider must also complete the Form CMS-576, Request for OPO
Designation.) In practical terms, “designation” means that CMS has approved the OPO for coverage of services to transplant centers and that the OPO can begin submitting claims to Medicare.
There can be only one designated OPO per geographic service area. When an OPO is de-certified and its service area is opened for competition, the applicable CMS regional office publishes a notice in local newspapers. CMS then selects an OPO to take over the service area, using the process at 42 CFR §486.316. The OPO that CMS selects must first have been certified by CMS and must meet the qualifications for designation at 42 CFR §486.304. The OPO must also sign a provider agreement (Form CMS-576A) and participate in the Organ Procurement and Transplantation Network. (See CMS Pub. 100-07, chapter 2, sections 2810 and 2811.) Note that OPOs do not receive a State survey.
For more information on OPOs, refer to:
• Section 1138 of the Social Security Act
• 42 CFR §486.301 - §486.348
• Pub. 100-07, chapter 2, sections 2810 – 2819 (State Operations Manual).
For guidance on the appropriate contractor jurisdiction for incoming OPO applications, see CMS Pub. 100-04, chapter 1, section 20. Note that a hospital-based OPO must enroll separately, be separately certified, and sign its own provider agreement. However, the hospital’s Medicare contractor will service the OPO, and the OPO will not receive its own CMS Certification Number.
An OPO is an organization that performs or coordinates the procurement, preservation, and transport of organs, and maintains a system for locating prospective recipients for available organs. There are three general steps involved in becoming a Medicare OPO: enrollment, certification and designation.
Certification means that CMS has determined that an OPO meets the requirements for certification at 42 CFR §486.303. It does not mean, however, that the OPO can begin billing for services. CMS must first assign (or “designate”) a geographic service area to the OPO. (The provider must also complete the Form CMS-576, Request for OPO
Designation.) In practical terms, “designation” means that CMS has approved the OPO for coverage of services to transplant centers and that the OPO can begin submitting claims to Medicare.
There can be only one designated OPO per geographic service area. When an OPO is de-certified and its service area is opened for competition, the applicable CMS regional office publishes a notice in local newspapers. CMS then selects an OPO to take over the service area, using the process at 42 CFR §486.316. The OPO that CMS selects must first have been certified by CMS and must meet the qualifications for designation at 42 CFR §486.304. The OPO must also sign a provider agreement (Form CMS-576A) and participate in the Organ Procurement and Transplantation Network. (See CMS Pub. 100-07, chapter 2, sections 2810 and 2811.) Note that OPOs do not receive a State survey.
For more information on OPOs, refer to:
• Section 1138 of the Social Security Act
• 42 CFR §486.301 - §486.348
• Pub. 100-07, chapter 2, sections 2810 – 2819 (State Operations Manual).
For guidance on the appropriate contractor jurisdiction for incoming OPO applications, see CMS Pub. 100-04, chapter 1, section 20. Note that a hospital-based OPO must enroll separately, be separately certified, and sign its own provider agreement. However, the hospital’s Medicare contractor will service the OPO, and the OPO will not receive its own CMS Certification Number.
No comments:
Post a Comment