Medicaid DMEPOS Supplier Bond - Statewide in Texas

Brief Summary

Texas Medicaid will not enroll or re-enroll a DME supplier without its own $50,000 bond naming HHSC, and the Medicare DMEPOS bond you already carry does not count. This bond is written on TMHP form F00092, once per enrolled location, and goes in with the Texas Medicaid enrollment application.

Every newly enrolling and re-enrolling durable medical equipment provider in Texas Medicaid must furnish a surety bond of at least $50,000 for each enrolled location, on the State of Texas Medicaid Provider Surety Bond form with the Health and Human Services Commission as obligee. The authority is 1 TAC 352.15, and TMHP spells out the filing rules in section 1.1.6 of the Texas Medicaid Provider Procedures Manual.

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How to Apply for a Medicaid DMEPOS Supplier Bond:

• Count the enrolled locations. Each one needs at least $50,000 of bond.
• Have the surety issue the bond on TMHP form F00092 with HHSC as obligee. No other form is accepted.
• Set the effective date no later than the application submission date and no earlier than 12 months before it.
• Submit the bond with the Texas Medicaid enrollment or re-enrollment application.
• Before the good through date, file proof of continuation through a Maintenance, Practice Location, Surety Bond request in PEMS.

Detailed Information About the Texas Medicaid DMEPOS Supplier Bond:

Your Medicare bond does not satisfy Texas

Medicare DMEPOS suppliers generally post a $50,000 bond to CMS under 42 CFR 424.57(d). TMHP is explicit that surety bonds obtained for accreditation in the Medicare program, which list CMS as obligee, do not fulfill the surety bond requirement for Texas Medicaid. A separate bond naming HHSC is required.

Amount and who posts it

The TMHP manual says all newly enrolling and re-enrolling DME providers must obtain a surety bond as a condition of enrollment and continued participation, in an amount of no less than $50,000 for each enrolled location. The underlying rule, 1 TAC 352.15, lets HHSC require bonds from provider types with a significant history of, or potential for, fraud, waste or abuse, and sets the same $50,000 floor.

The rule exempts an entity operated or administered by a federal, state, local or tribal government agency, provided it had no uncollected Medicaid or CHIP overpayments during the preceding five years.

The bond form and its terms

TMHP accepts only the State of Texas Medicaid Provider Surety Bond form, F00092. It names the provider as principal and HHSC as obligee. Under 1 TAC 352.15 the surety must be licensed by the Texas Department of Insurance and hold a valid certificate of authority from the U.S. Department of the Treasury. The bond guarantees payment of uncollected overpayments, as defined in 42 CFR 433.304, and the surety stays liable for overpayments arising during the bond term for two years after the bond is canceled or expires. Cancellation takes effect 30 days after notice of cancellation is sent to the obligee's contractor.

Dates that cause rejections

The effective date must be no later than the day the enrollment application is submitted and no earlier than 12 months before that day. TMHP wants a bond issued for a 12 month term that is continuous, meaning it stays in force from term to term until canceled. An annual bond that states fixed effective and expiration dates is not accepted.

Keeping it in force

Before the bond on file reaches its good through date, the supplier submits proof of continuation by opening a Maintenance, Practice Location, Surety Bond request in PEMS. The continuation must show the bond number, the original bond date, the new good through date and original signatures of the provider's authorized representative and the surety's attorney in fact. HHSC will not pay for items or services furnished during any period without a current bond.

Eligibility and Requirements for a Texas Medicaid DMEPOS Supplier Bond:

• Minimum $50,000 bond for each enrolled location.
• Health and Human Services Commission named as obligee. A bond naming CMS does not qualify.
• Surety licensed by the Texas Department of Insurance with a U.S. Treasury certificate of authority.
• Continuous bond on a 12 month term, not an annual bond with fixed start and end dates.
• Surety liability for uncollected overpayments for two years after cancellation or expiration.

Texas Medicaid DMEPOS Supplier Bond FAQs:

Official and Additional Resources for the Texas Medicaid DMEPOS Supplier Bond: