Durable Medical Equipment Supplier Frequently Asked Questions

Contents
Applying and renewing
Changes and updates
Complaints, investigations, and administrative hearings
General questions
Online access and electronic filing




Complaints, investigations, and administrative hearings

Q1. How do I file a complaint concerning a durable medical equipment supplier, equipment, or services?

A1. You may file a complaint on the DME home page, using the complaint form (PDF) under the Complaints heading. Your complaint must be in writing and must be notarized.

In addition, Colorado law requires the Secretary of State to refer such complaints to the Federal Centers for Medicare and Medicaid Services (also known as CMS).



Q2. I am a DME supplier and have received a Notice of Complaint. What do I do now?

A2. For all complaints, DME suppliers will receive a Notice of Complaint, which will explain any allegations of violations of the DME statute §24-21-115 C.R.S. In most cases, the notice will be accompanied with a request for a Plan of Correction. You will be given a deadline to return a Plan of Correction, which must:

  1. Explain how the violation/deficiency will be corrected, and
  2. The date upon which the violation/deficiency will be corrected

If you feel that a violation has not occurred, you will be given time to respond in writing with your arguments, views, and supporting data to show no violation has occurred.

It is important to respond within the time frame provided.



Q3. I am a DME supplier and have received a Notice of Complaint, but have not received a request for a Plan of Correction. What do I do now?

A3. If you feel that a violation has not occurred, you will be given time to respond in writing with your arguments, views, and supporting data to show no violation has occurred.

In some cases, such as a DME supplier’s failure to be accredited or failure to have a physical address within one hundred (100) miles of any Colorado resident medicare beneficiary, the Office of the Secretary of State will provide time to respond to the Notice of Complaint, but may deem it necessary to move forward with suspension or revocation proceedings in order to protect public health, safety, and welfare.



Q4. What type of violations could lead to the suspension or revocation of a DME supplier license?

A4. Please see chart below.

Type of violation

Statutory reference

Elements

Geographic violations

§24-21-115(3)(b)(I), C.R.S.

  • At least one accredited physical facility
  • Within 100 miles
  • Of any (interpreted as at least one) Colorado resident medicare beneficiary
  • Served by DME supplier

Accreditation violation

§24-21-115(3)(b)(III), C.R.S.

Must be accredited by an organization recognized and accepted by the federal centers for Medicare and Medicaid Services

Staffing violation

§24-21-115(3)(b)(I), C.R.S.

  • Physical facility must be sufficiently staffed
  • During reasonable business hours

§24-21-115(3)(b)(II), C.R.S.

Must have sufficient staff to service or repair products

Business hours violation

§24-21-115(3)(b)(I), C.R.S.

Physical facility must be open during reasonable business hours

Sufficient inventory violation

§24-21-115(3)(b)(II), C.R.S.

There must be sufficient inventory

License violation

§24-21-115(4) C.R.S.

License must be prominently displayed at each physical business location



Q5. As a DME supplier, what are my rights up to and during an administrative hearing process for suspension or revocation of my license?

A5. You have the right to notice of the complaint, a full investigation, and an administrative hearing.

Throughout the complaint, investigation, and suspension/revocation process the Office of the Secretary of State will follow all due process requirements and will follow the rules set forth by the Administrative Procedure Act §24-4-104, C.R.S. and §24-4-105, C.R.S.

We do not represent you. Any action that we take is on behalf of the state and citizens in general. Should you require legal advice, we recommend you seek independent legal counsel.



Q6. I am a DME supplier and my license has been denied. What do I do now?

A6. Within sixty (60) days of your receipt of the Notice of Denial, you may request a hearing before the Office of the Secretary of State. The Office of the Secretary of State will follow all due process requirements and will follow the rules set forth by the Administrative Procedure Act §24-4-104, C.R.S. and §24-4-105, C.R.S. and §24-4-106, C.R.S.

We do not represent you. Any action that we take is on behalf of the state and citizens in general. Should you require legal advice, we recommend you seek independent legal counsel.



Q7. I am a DME supplier and my license has been suspended/revoked. What do I do now?

A7. If your license has been suspended/revoked you must follow the decision of the agency or the administrative law judge, depending on who oversees the proceedings. Should you seek to reverse or modify the decision or seek judicial review, you may do so by following the rules set forth by the Administrative Procedure Act §24-4-105, C.R.S. and §24-4-106, C.R.S.

Please be mindful that there are important deadlines to be met when seeking the above remedies.

We do not represent you. Any action that we take is on behalf of the state and citizens in general. Should you require legal advice, we recommend you seek independent legal counsel.

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