The Social Security Act states that durable medical equipment (DME) may only be billed to Part B of the Medicare program if the equipment is provided in the beneficiary’s residence. However, the law specifies that a nursing facility cannot be considered a residence.

There is a large population of frail, elderly Medicare beneficiaries currently residing in nursing facilities. For this population, nursing home residence is the only viable option and is in fact their legal residence. Although they are currently paying for the Part B benefit, these beneficiaries may be denied access to clinically necessary DME if they continue to reside in a nursing facility beyond the initial 100 days of Part A care. Since more than 80% of the total patient days in nursing facilities are not covered by Part B, the overwhelming majority of residents in nursing facilities fall through the cracks of the Medicare safety net and are without a DME benefit.