Current through Vol. 42, No. 1, September 16, 2024
(a)
Licensing
requirement. Before conducting interstate and/or intrastate transactions
in Oklahoma, a Durable Medical Equipment supplier (DME) or a combined DME
Supplier and Medical Gas Distributor (DME+MGD) shall register annually with the
Board.
(1) A DME or DME+MGD license is only
valid for the name, ownership and location listed on the license. Changes of
name, ownership or location shall require a new DME supplier license.
(2) Changes in any information required for
licensure must be reported to the Board within ten (10) days (e.g., manager,
contact person, phone, etc.).
(3)
Each location shall possess a DME or DME+MGD license. A DME or DME+MGD license
entitles the license holder to store and supply DME at the licensed
location.
(4) Each facility at
which DME is stored, warehoused, handled, held, offered, marketed, or displayed
shall be licensed by the Board and be of suitable size and construction to
facilitate cleaning, maintenance, and proper operations.
(5) As allowed under 59 OS Section 375.3 (D)
an out-of-state DME supplier will not be required to maintain a physical office
or place of business within Oklahoma or within one hundred (100) miles of a
resident of Oklahoma being served by the DME supplier if the following
conditions are met,
(A) They are supplying a
specialized DME product/device,
(B)
The specialized DME product/device is not available through standard local DME
channels, and
(C) They are
accredited by an organization that is recognized by the Centers for Medicare
and Medicaid Services.
(6) A DME supplier shall not operate from a
place of residence.
(7) A DME
supplier shall not operate from a storage unit.
(b)
License issuance. Licenses
shall be issued only to those DME or DME+MGD who satisfy the provisions of 59
O.S. Section 375.1 through 375.5, and the requirements under the Act, this
Title, and the rules in 535:25 for applicants.
(c)
Compliance with federal
requirements. DME or DME+MGD applicants and registrants must comply with
all applicable federal, state, or local laws and regulations. DME+MGD
applicants and registrants shall be registered with the federal Food and Drug
Administration (FDA), if required.
(d)
Minimum required information for
licensure. The minimum required information for DME or DME+MGD licensure
shall be as follows, applicants must submit a satisfactorily completed
application together with the required fee annually. This application shall
include, at least, the following:
(1) The
name, full business address, and telephone number.
(2) All trade or business names used by the
applicant.
(3) Address, telephone
numbers, and the names of contact persons for the facility.
(4) The type of ownership or operation (e.g.,
partnership, corporation, or sole proprietorship).
(5) The name(s) of the owner and/or operator
of the applicant; and
(6) Any other
information the Board deems necessary to protect the public health.
(e)
Minimum
qualifications. DME and DME+MGD must conform to all applicable federal,
state, or local laws and regulations.
(1) The
minimum qualifications shall be the same as those set forth in 535:25 and this
Chapter. The Board shall consider, at a minimum, the following factors in
reviewing the qualifications of persons who engage in the supplying of DME:
(A) Any convictions of the applicant under
any federal, state, or local laws relating to DME, devices, drugs, drug
samples, manufacture, packager, wholesale or retail drug distribution, or
distribution of controlled substances.
(B) Any felony convictions of the applicant
under federal, state, or local laws.
(C) The applicant's past experience in the
handling, manufacture, packaging, or distribution of DME, devices, drugs,
including controlled substances.
(D) The furnishing by the applicant of false
or fraudulent material in any application made in connection with DME, device,
or drug handling, manufacturing, packing, or distribution.
(E) Suspension, sanction, or revocation by
federal, state, or local government of any license currently or previously held
by the applicant for the handling, manufacture, packaging, or distribution of
any DME, devices, drugs, including controlled substances; or by any of its
owners for violation of state or federal laws regarding DME, devices, or
drugs.
(F) Compliance with
licensing requirements under previously granted licenses, if any.
(G) Compliance with requirements to maintain
and/or make available to the State Board or to federal, state, or local law
enforcement officials those records required under this section; and,
(H) Any other factors or qualifications the
Board considers relevant to and consistent with the public health and
safety.
(2) The Board
shall have the right to deny a license to an applicant if it determines that
the granting of such a license would not be consistent with the public health
and safety.
(f)
Personnel. Personnel employed by DME or DME+MGD suppliers shall
have sufficient education, training, and/or experience to perform assigned
functions and comply with federal, state, and local licensing requirements.
Personnel involved with the delivery, maintenance, and repair of DME shall
complete annual continuing education.
(g)
Minimum requirements for storage,
handling, and records. DME or DME+MGD suppliers must meet minimum
requirements for storage and handling, and for the establishment and
maintenance of distribution records for DME. The following shall describe the
minimum requirements for the storage and handling of DME, and for the
establishment and maintenance of DME records by DME or DME+MGD suppliers and
their officers, agents, representatives, and employees.
(1)
Security. Each facility used
for DME shall be secure from unauthorized entry.
(A) Access from outside the premises shall be
kept to a minimum and be well controlled.
(B) The outside perimeter of the premises
shall be well-lighted.
(C) Entry
into areas where DME are held shall be limited to authorized
personnel.
(D) All DME suppliers
shall establish and maintain controls and systems that protect against, detect,
and document any instances of theft, diversion, or counterfeiting. When
appropriate, the security system shall provide protection against theft or
diversion that is facilitated or hidden by tampering with computers or
electronic records.
(E) All DME
suppliers shall establish and maintain a suspicious order monitoring program
for DME.
(i) The DME or DME+MGD supplier must
not ship the customer's order if the order is confirmed as
suspicious.
(ii) Each DME or
DME+MGD supplier shall notify the Board, within ten (10) days, if an order is
confirmed as suspicious; and,
(iii)
DME or DME+MGD suppliers shall establish guidelines and procedures for
identifying suspicious orders.
(2)
Storage. All DME shall be
stored at appropriate temperatures and under appropriate conditions in
accordance with requirements, if any, in the labeling of such DME.
(A) If no storage requirements are
established for DME, the DME may be held at "controlled" room temperature, as
defined in an official compendium, to help ensure that it is not adversely
affected.
(B) Appropriate manual,
electromechanical, or electronic temperature and humidity recording equipment,
devices, and/or logs shall be utilized to document proper storage of DME, if
required.
(C) Storage areas should
be designed to provide adequate lighting, ventilation, temperature, sanitation,
humidity, space, equipment, and security conditions.
(D) Storage areas must have a quarantine area
for storage of DME that are outdated, damaged, deteriorated, misbranded, or
adulterated, or that are in immediate or sealed, secondary containers that have
been opened.
(E) Storage areas must
be maintained in a clean and orderly condition and, be free from infestation by
insects, rodents, birds, or vermin of any kind.
(F) The recordkeeping requirement in this
Chapter for DME suppliers shall be followed for all stored DME.
(3)
Examination of
materials. Upon receipt, each shipment of DME shall be visually examined
for identity and to prevent the acceptance of damaged DME. This examination
shall be adequate to reveal damage to the DME.
(A) Each outgoing shipment shall be carefully
inspected for identity of the DME and to ensure that there is no delivery of
DME that have been damaged in storage or held under improper
conditions.
(B) The recordkeeping
requirement in this Chapter shall be followed for all incoming and outgoing
DME.
(4)
Returned,
damaged, and outdated DME. DME that are outdated, damaged, deteriorated,
misbranded, or adulterated shall be quarantined and physically separated from
other DME until they are destroyed.
(A) If
the conditions under which DME has been returned cast doubt on the DME's safety
or quality, then the DME shall be destroyed, unless examination or other
investigation proves that the DME meets appropriate standards of safety and
quality. In determining whether the conditions under which DME has been
returned cast doubt on the DME's safety and quality, the DME supplier shall
consider, among other things:
(i) The
conditions under which the DME has been held, stored, or shipped before or
during its return; and,
(ii) The
condition of the DME carton, or labeling, as a result of storage or
shipping.
(B) The
recordkeeping requirements for DME or DME+MGD suppliers in this Chapter shall
be followed for all outdated, damaged, deteriorated, misbranded, or adulterated
DME.
(5)
Recordkeeping. DME or DME+MGD suppliers shall establish and
maintain inventories and records of all transactions regarding the receipt and
distribution or other disposition of DME.
(A)
Inventories and records shall be made available for inspection and photocopying
by authorized federal, state, or local law enforcement agency officials for a
period of two (2) years following disposition of the DME.
(B) Records described in this section that
are kept at the inspection site or that can be immediately retrieved by
computer or other electronic means shall be readily available for authorized
inspection during the retention period. Records kept at a central location
apart from the inspection site and not electronically retrievable shall be made
available for inspection within two (2) working days of a request by an
authorized official of a federal, state, or local law enforcement
agency.
(C) Each DME or DME+MGD
supplier should maintain an ongoing list of persons with whom they do
business.
(6)
Written policies and procedures. DME or DME+MGD suppliers shall
establish, maintain, and adhere to written policies and procedures, which shall
be followed for the receipt, security, storage, inventory, and distribution of
DME, including policies and procedures for identifying, recording, and
reporting losses or thefts, and for correcting all errors and inaccuracies in
inventories.
(A) DME or DME+MGD suppliers
shall include in their written policies and procedures the following: A
procedure to be followed for handling recalls and withdrawals of DME. Such
procedure shall be adequate to deal with recalls and withdrawals due to any:
(i) Action initiated at the request of the
Food and Drug Administration (FDA) or other federal, state, or local law
enforcement or other government agency, including the Board,
(ii) Voluntary action by the DME or DME+MGD
supplier to remove defective or potentially defective DME from the market;
or
(iii) Action undertaken to
promote public health and safety by replacing of existing merchandise with an
improved product or new package design.
(B) A procedure to ensure that DME or DME+MGD
suppliers prepare for, protect against, and handle a crisis that affects
security or operation of any facility in the event of strike, fire, flood, or
other natural disaster, or other situations of local, state or national
emergency.
(C) A procedure to
ensure that any outdated DME shall be segregated from other DME and destroyed.
(i) This procedure shall provide for written
documentation of the disposition of outdated DME.
(ii) This documentation shall be maintained
for two (2) years after disposition of the outdated DME.
(7)
Responsible
persons. DME or DME+MGD suppliers shall establish and maintain lists of
officers, directors, managers, and other persons in charge of DME distribution,
storage, and handling, including a description of their duties and a summary of
their qualifications.
(8)
Compliance with federal, state and local laws. DME or DME+MGD
suppliers shall operate in compliance with applicable federal, state, and local
laws and regulations. DME suppliers shall permit the Board and authorized
federal, state, and local law enforcement officials to enter and inspect their
premises and delivery vehicles, and to audit their records and written
operating procedures and to confiscate records, to the extent authorized by law
and rule.
(9)
Salvaging and
reprocessing. DME or DME+MGD suppliers shall be subject to the
provisions of any applicable federal, state, or local laws or regulations that
relate to DME product salvaging or reprocessing.
(h)
Prescription requirement.
DME or DME+MGD suppliers shall not supply DME without a prescription order.
(1) An original or copy of a prescription
order must be kept at the licensed location supplying the DME.
(2) A prescription DME order is only valid
for one (1) year. Prescription DME orders shall be maintained for five years
and be readily retrievable and available at inspection.
(i)
DME+MGD Compliance. All
DME+MGD must comply with the requirements in
535:20-9-4 for medical gas
distributors.