Current through September 24, 2024
1. Permit required:
Pursuant to Mississippi Pharmacy Practice Act Section
73-21-108
no person, business or entity subject to this chapter shall sell, rent or
provide or offer to sell, rent or provide directly or indirectly to consumers
in this state any home medical equipment, legend devices, and/or medical gas
unless such person, business or entity first obtains a Medical Equipment
Suppliers Permit from the Mississippi Board of Pharmacy. Permitting procedures
are as follows:
A. The permitting
requirements of this section will apply to all companies, agencies and other
business entities that are in the business of supplying home medical equipment
to patients in residential settings and which bill the patient or the patient's
insurance, Medicare, Medicaid or other third party payor for the rent or sale
of that equipment.
B. The
application for a permit shall be on a form supplied by the Board and
accompanied by a fee of $150.00. Once issued, every permit must be renewed
annually. The renewal fee shall not exceed $150.00.
C. The Board shall require a separate permit
for each facility location directly or indirectly owned or operated in this
state. Permits shall not be issued for facilities located in a residence.
D. All permits issued under this
section shall expire annually on June 30, of each year. Application and payment
for renewal must be postmarked on or before June 30 and must be accompanied by
the fee as prescribed by this section. A penalty of $50.00 shall be added to
all late renewals postmarked after June 30, of each renewal period. The Permit
shall become null and void if the renewal application and renewal fee are not
received by July 1 of each year.
E.
The person who signs the application for a medical equipment suppliers permit
or the renewal of a medical equipment suppliers permit shall be the permit
holder for that facility and shall be responsible for all activities in the
permitted facility which are subject to regulation by the Board. Once issued, a
permit cannot be amended, transferred or assigned to another person.
F. If the employment of a permit holder is
terminated or if for any other reason he/she wishes to be relieved of the
responsibilities of the permit holder, he/she must return the medical equipment
suppliers permit to the Mississippi Board of Pharmacy with written notice that
he/she is no longer the permit holder for that facility. When a permit is thus
returned, application for a new permit for that facility must be made to the
Mississippi Board of Pharmacy within ten (10) days.
G. If a permitted facility is permanently
closed or has a change of ownership, the permit holder for that facility shall
give notice to the Board of the effective date of closure or change in
ownership at least ten (10) days prior to the closure or change of
ownership.
H. If a permitted
facility has a change in name or location, a new permit must be obtained.
Application for this new permit must be made to the Board at least ten (10)
days prior to the change.
I. The
Board shall not issue any original or annual renewal medical equipment permit
until the Board is satisfied that:
(1)
Adequate qualified personnel have been secured by management of the facility to
properly render medical equipment services in the manner prescribed by law; and
(2) Such personnel shall be
maintained during the period for which the permit is issued; and
(3) Suitable facilities shall be maintained
to house inventory, to allow for equipment maintenance work space and the
storage and retrieval of all records required to be kept; and
(4)
Repealed 2013
(5) A copy of these regulations
shall be present in the facility at all times; and
(6) The facility is kept in a clean, orderly
and sanitary condition at all times; and
(7) The applicant's services are accessible
to its customer base; and
(8) The
applicant complies with all USP, FDA, DOT and OSHA requirements regarding the
storage, packaging, labeling and shipping of medical equipment including
medical gases; and
(9) The
applicant's services are available twenty-four (24) hours, seven (7) days per
week when essential to the maintenance of life or when lack of services might
reasonably cause harm; and
(10) The
applicant implements and maintains a written procedure at each location for
handling complaints and problems, which includes a complaint file documenting
complaints and problems and resolution of the complaints and problems; and
(11) The applicant complies with
all local/state fire and building laws; and
(12) The facility is equipped with a
functioning lavatory where hot and cold running water or hand washing
appliances or waterless hand cleaner are available; and
Exemptions are as follows:
A. The permitting requirements of this
section do not apply to the following unless the following have a separate
business entity, company, corporation or division that is in the business of
providing home medical equipment to patients at their home: home health
agencies; hospitals; wholesalers and/or manufacturers; medical doctors,
physical therapists, respiratory therapists, occupational therapists, speech
pathologists, optometrists, chiropractors and podiatrists who use home medical
equipment and/or legend devices in their individual practices; pharmacies;
hospice programs; nursing homes and or long term care facilities;
veterinarians; dentists; and emergency medical services.
B. Community pharmacies, long term care
facilities and hospitals although excluded from permitting requirements of this
section, will be subject to the same regulations for the sale or rental of home
medical equipment covered by this section.
C. It is also recognized that oxygen, liquid
oxygen and/or legend devices may be used in emergencies by trained individuals.
D. Nothing in this section shall
prohibit the pre-hospital emergency administration of oxygen by licensed health
care providers, emergency medical technicians, first responders, fire fighters,
law enforcement officers and other emergency personnel trained in the proper
use of emergency oxygen.
Article XXXVIII, Paragraph 1-D REPEAL (Effective
3/6/14) Section was re-numbered after filing final repeal on 2/4/14. MS
Administrative Bulletin System Number 20320
2. Medical
Equipment Advisory Committee (MEAC) to the Board:
A. A MEAC committee, composed of three (3)
members selected by the Mississippi Association of Medical Equipment Suppliers
and approved by the Board, shall review and make recommendations to the Board
on the merit of all regulations dealing with home medical equipment, legend
devices and medical gases, which are proposed by the Board and before they are
adopted by the Board.
Newly appointed MEAC members shall be assigned to Post 1.,
Post 2. or Post 3. Subsequent terms of MEAC members shall be for a period of
five (5) years and no member shall serve two consecutive terms.
B. All MEAC members shall have
been actively involved in the home medical equipment business for a minimum of
five (5) years and shall hold and maintain, in good standing, a permit issued
by the Board pursuant to this section.
C. The MEAC members shall meet at least
quarterly and review all home medical equipment suppliers' inspection reports.
All complaints and reports of investigations of violation of law or regulations
shall first be reviewed by the MEAC. After review, the MEAC may make
recommendations to the Board's Investigations Review Committee as to further
administrative action by the Board.
D. The MEAC shall keep and maintain minutes
of all meetings of the MEAC and shall provide copies of said minutes to the
Board on a quarterly basis.
E. The
Mississippi Board of Pharmacy may remove any or all MEAC members on proof of
unprofessional conduct, continued absence from the state, being found guilty of
any provisions of these regulations or other regulations of the state or
federal government or failure to perform the duties of his/her office. Any MEAC
member who shall not attend two (2) consecutive regular meetings of the MEAC
for any reason other than illness shall be subject to removal by the
Mississippi Board of Pharmacy.
3. Order Required:
Home Medical Equipment Suppliers shall not provide any legend
device or medical gas to a patient without a valid order from an authorized
practitioner all orders must be readily retrievable and must be produced on
request by a compliance agent. All legend items, including oxygen, require a
new prescription order on a yearly basis.
4. Medical gas, oxygen and respiratory
equipment suppliers shall:
A. Comply with all
applicable home medical equipment laws and regulations of Mississippi; and
B. If transporting oxygen and
other medical gases in cylinder or liquid form, comply with all current
Department of Transportation rules and regulations; and
C. If transfilling medical oxygen systems,
comply with Food and Drug Administration (FDA) and all state agency
requirements regarding transfilling and repackaging; and
D. Demonstrate that oxygen and other medical
gases provided in cylinder or liquid form meets minimum purity standards for
medical grade oxygen and medical gases; and
E. Meet the following safety inspection
requirements:
(1) Demonstrate that each piece
of oxygen/respiratory equipment has been checked, is free of defects and
operates within the manufacturer's specifications; and
(2) Refrain from modifying equipment to the
extent that the modification might reasonably cause harm; and
(3) Maintain all electrical components so
that they do not present fire or shock hazard; and
(4) Ensure that all appropriate warning
labels or labeling, including tags, are present on the equipment provided.
I. Medical gas, oxygen and respiratory
related equipment suppliers shall comply with the following recall procedures:
A. Ensure that lot numbers and expiration
dates are affixed to each cylinder delivered; and
B. Maintain a tracking system for all medical
oxygen and gas delivered; and
C.
Document all equipment serial numbers and model numbers to ensure that
equipment can be retrieved if a recall is initiated; and
D. Maintain records for equipment that
requires FDA tracking.
II. Medical gas, oxygen and respiratory
related equipment suppliers shall comply with the following maintenance and
cleaning requirements:
A. Maintain
documentation demonstrating that a function and safety check of equipment was
performed prior to set up; and
B.
Maintain an established protocol for cleaning and disinfecting equipment which
addresses both aerobic and anaerobic pathogens; and
C. Maintain a Material Safety Data Sheet
(MSDS) on file for solutions and products used in cleaning and disinfecting
procedures; and
D. Maintain
segregated areas on the premises and in delivery vehicles for clean, dirty, and
contaminated equipment; and
E.
Clean and disinfect equipment according to manufacturers' specifications; and
F. Instruct the patient on proper
cleaning techniques as specified by the manufacturer; and
G. Ensure that all medical gas, oxygen and
respiratory related equipment is properly identified by a tag or label as to
it's current status of use, i.e. out of order or ready for use.
III. Medical gas, oxygen and
respiratory related equipment suppliers shall implement a comprehensive
preventative maintenance program which includes the following:
A. Procedures for problem reporting,
tracking, recall, and resolution; and
B. Performance of service as specified by the
manufacturer and the documentation of such performance in the service records;
and
C. Routine inspection, service,
and maintenance of equipment located in the patient's/customer's home according
to manufacturers' specifications.
IV. Medical gas, oxygen and respiratory
related equipment suppliers shall maintain repair logs to document repair and
maintenance of equipment, including, but not limited to, oxygen concentrators,
infant monitors, and mechanical ventilators. The following information shall be
documented in the repair log:
A. type of
equipment; and
B. manufacturer;
and
C. model; and
D. serial number; and
E. date of repair; and
F. specific repair made; and
G. name of person or company performing the
repair.
V. Medical gas,
oxygen and respiratory related equipment suppliers shall maintain testing
equipment to ensure accurate calibration. Testing equipment shall be
appropriate for the level of service offered. Scales used to weigh liquid
oxygen reservoirs shall be properly maintained to ensure accuracy.
VI. Medical gas, oxygen and respiratory
related equipment suppliers shall implement a written procedure at each
location for handling complaints and problems, which includes a complaint file
documenting complaints and problems and resolutions of the complaints or
problems.
VII. Medical gas, oxygen
and respiratory related equipment suppliers shall comply with the following
counseling requirements:
A. Utilize
orientation checklists to review:
(1)
Instructions for use of the equipment; and
(2) Safety precautions; and
(3) Cleaning procedures; and
(4) Maintenance procedures; and
(5) Return demonstrations on back up oxygen
systems delivered; and
B.
Instruct the patient about emergency and routine contact procedures;
and
C. Deliver and review written
instruction materials to ensure that the patient receives adequate information
in order to properly operate the equipment.
A written plan of service shall be developed, implemented, and
documented in the patient record. The plan of service shall include, but is not
limited to, an assessment of the safety of the home environment, the care giver
or patient ability to comply with the order, and the care giver or patient
ability to operate and clean the equipment as instructed.
5.
Other Medical Equipment
Persons that shall sell, rent and/or provide other medical
equipment or legend devices, as defined in these regulations, shall also comply
with the following:
A. Provide proper
training of personnel for the safe delivery and use of any medical equipment or
legend device; and
B. Ensure that
all manufacturer's recommended assembly and maintenance procedures are
followed; and
C. Meet the following
safety inspection requirements:
(1)
Demonstrate that each piece of medical equipment or legend device has been
checked, is free of defect and operates within the manufacturer's
specifications; and
(2) Refrain
from modifying equipment to the extent that the modification might reasonably
cause harm; and
(3) Maintain all
electrical components so that they do not present fire or shock hazard;
and
(4) Ensure that all appropriate
warning labels or labeling, including tags, are present on the equipment
provided.
6.
Revocation, Suspension or Restriction, Penalties of Permit shall be as follows:
A. The Board may revoke, suspend, restrict,
refuse to issue or renew or impose a monetary penalty, in accordance with
Section
73-21-103.
Mississippi Code of 1972, Annotated, if the business or holder of a permit or
applicant for a permit, issued under this section, has committed or is found
guilty by the Board of any of the following:
(1) Violation of any Federal, State or local
law or regulation relating to medical equipment, legend devices or medical
gases.
(2) Violation of any of the
provisions of these regulations.
(3) Commission of an act or engaging in a
course of conduct which constitutes a clear and present danger to the public
health and safety.
(4) Filing a
claim or assisting in the filing of a claim for reimbursement for medical
equipment, medical gases, legend devices or professional services which were
not provided or which were not authorized to be provided.
(5) Failure to comply with any lawful order
of the Board.
(6) Conviction of a
felony.
(7) Entering into any
written agreements or other activities which interferes with or otherwise
denies a patient the freedom to choose any willing provider of medical
equipment or services.
B.
Disciplinary action by the Board against a business or any person holding a
permit pursuant to this section shall be in accordance with Section
73-21-99
of the Mississippi Code of 1972, Annotated.
Definitions:
For purposes of these regulations:
A. "Home Medical Equipment" means
technologically sophisticated medical equipment and devices usable in a home
care setting including, but not limited to:
(1) Oxygen for human consumption, oxygen
concentrators, and/or oxygen delivery systems and equipment;
(2) Ventilators;
(3) Respiratory disease management devices;
(4) Electronic and computer driven
wheelchairs and seating systems;
(5) Apnea monitors;
(6) Transcutaneous electrical nerve
stimulator (TENS) units;
(7) Low
air loss cutaneous pressure management devices;
(8) Sequential compression devices;
(9) Neonatal home phototherapy
devices;
(10) Feeding
pumps;
(11) And other similar
equipment as defined in any regulations established by the
Board.
B. "Home Medical
Services" means the delivery, installation, maintenance, replacement, and/or
instruction in the use of home medical equipment, used by a sick or disabled
individual, to allow the individual to be cared for and maintained in a home or
non-institutional environment.
C.
"Medical gas" means those gases and liquid oxygen intended for human
consumption.
D. "Order" means an
order issued by a licensed medical practitioner legally authorized to order
medical gases, legend devices and/or home medical equipment.
E. The term "Home Medical Equipment" does not
mean medical equipment used in the normal course of treating patients by
hospitals, hospices, long term care facilities or home health agencies or
medical equipment used or dispensed by health care professionals licensed by
the State of Mississippi---provided that the professional is practicing within
the scope of his/her professional practice. Further, that items such as upper
and lower extremity prosthetics, canes, crutches, walkers, bathtub grab bars,
standard wheelchairs, commode chairs and bath benches are not considered to be
home medical equipment.
F.
"Pharmacy Board, State Board of Pharmacy or Board" shall mean the Mississippi
Board of Pharmacy.
G. The term
"Legend Device" shall mean any instrument, apparatus, implement, machine,
contrivance, implant, in vitro reagent or other similar or related article,
including any component part or accessory which is required under federal or
state law to be prescribed or ordered by a physician and/or
practitioner.