CMS Pub. 100-04, ch. 20, § 110.3.3

1. A facility remains responsible for furnishing medically necessary items to a

beneficiary for the full duration of a beneficiary's stay. The DRG and PPS rates cover

such items.

2. A facility may not delay furnishing a medically necessary item for the beneficiary's use

or treatment while the beneficiary is in the facility. A facility may not prematurely

remove a medically necessary item from the beneficiary's use or treatment on the basis

that a supplier delivered a similar or identical item to the beneficiary for the purpose of

fitting or training.

3. A facility may not, through a stratagem of relying upon a supplier to furnish such

items, improperly shift its costs for furnishing medically necessary items to a beneficiary

who is a resident in the facility to Medicare Part B.

Nevertheless, beginning two days before the beneficiary's discharge, a facility may take

reasonable actions to permit a supplier to fit or train the beneficiary with the medically

necessary item that is for subsequent use in the beneficiary's home. These actions may

include the substitution of the supplier-furnished item, in whole or in part, for the facility-

furnished item during the beneficiary's last two inpatient days provided the substitution is

both reasonable and necessary for fitting or training and the item is intended for

subsequent use at the beneficiary's home.

4. For prosthetic and orthotic (P&O) items, the above restrictions apply to residents in a

covered Part A stay. For DME, the above restrictions apply in a covered Part A or a Part

B stay.