I'm getting back into management at an Optical dispensary that fills rx's for Post Op cataract patients... I recently rec'd the following info from a "consultant" touting their services. The following was part of the propaganda package. Does anyone know if there's truth to the info? I read the referenced "Patient Protection and Affordable Care Act (Section 6401)" & didn't find mention of the following requirements.... The info came from a consultant in FL, but i work in both MN & ND. I'm wondering if these "requirements are valid & pertain to both ND & MN...anyone help me out? I admit i'm not the most knowledgable about medicare requirements & am looking for some guidance or direction i can reference to quickly get up to speed & not be "non compliant". The rec'd propaganda is as follows: thanks in advance!!



Licensed Optician On-Site is Critical Compliancy

In non-licensed states, ABO certified optician required.

If your state licenses opticians, be aware that to qualify as a DME Medicare Supplier will require that you show proof of the licensed optician on-site at your optical dispensary. The license will have to accompany your enrollment or revalidation documents. In non-licensed states, verification of ABO certification is required. This is part of the new DME Supplier enrollment criteria.


Many suppliers are under the impression that if the optician works under the “supervision” of a doctor (either MD or OD) this will automatically qualify their optical as a DME Supplier. This is not so. To qualify as a DME Supplier you must have a licensed or ABO certified optician at each location during the hours of operation as stated by the supplier in their enrollment or revalidation application.

 I have received many phone calls from doctors in optician licensed states that are being denied DME Supplier status because their optician is not licensed. I recently shopped several doctor owned opticals in Florida, a licensed state. I found opticals that did not have licensed opticians. When I asked if I could use my benefits for eyeglasses after cataract surgery, I was told "yes" because they were "certified DME Suppliers". Even if this is a stretch of Florida’s optician licensing requirements, DME Medicare would not qualify these opticals as Suppliers.

ABO certification does not take the place of licensure in a licensed state and should not be displayed if the optician is not licensed. The attorney generals office in Florida recently issued the following statement regarding opticals that only have ABO certified opticians: “displaying the (ABO) certificate would be a violation of the (FL) statute because it would lead someone to believe that the owner of the certificate is a licensed optician in Florida.” If you are both a licensed and ABO certified optician in Florida, display of ABO certification, as well as, your license is appropriate.


Beside optician licensure/certification, there are many other new compliancy issues for DME Suppliers. Medicare does not consider ignorance of the rules an excuse. DME Medicare has recovered millions of dollars in fraud from Medicare DME suppliers. While post-op cataract eyewear has not ranked high in this abuse investigation, all DME suppliers are now under close scrutiny.