Tallahassee, Fla.
A Florida state house bill was introduced last month that would
require the state's HME providers to become accredited in order to
obtain and maintain their state licenses.
According to some observers, this is welcome news in an area of
the country that has seen its share of Medicare fraud. “It
increases standards for providers throughout the state,” said
Javier Talamo of Kravitz & Talamo, Hialeah, Fla., and vice
president of the Florida Association of Medical Equipment Services
(FAMES).
House Bill 179 proposes mandatory accreditation for all Florida
DME suppliers, obtained from one of the industry's accrediting
bodies, including JCAHO (Joint Commission on the Accreditation of
Healthcare Organizations), CHAP (Community Health Accreditation
Program) and ACHC (Accreditation Commission for Health Care). FAMES
is hoping a similar bill will be introduced soon in the state
senate. The entire legislature returns to the state capitol in
March.
The idea for such a bill came from continual negotiations
between HME providers and state officials over proviso language in
the state budget passed last year. The language requires Medicaid
payments on most DME to be no more than 80 percent of current
rates. It also states that a “qualified vendor must be
nationally accredited and in good standing with the agency and
[CMS].” Although last year the language was interpreted to
mean “competitive bidding,” those words do not appear
in the proviso language.
The state's intent, Talamo said, is to shave 20 percent off of
what it pays for Medicaid DME claims. Through talks with state
officials, FAMES is hoping to produce those savings through two
proposals.
The first is the mandatory accreditation bill, which Talamo said
will reduce fraud and, ultimately, save the state about 10 percent.
The rest of the savings would come from across-the-board reductions
of DME Medicaid reimbursement to occur incrementally over several
years.
