CMS Releases Accreditation Rule, but Still No Quality Standards

BALTIMORE–In a final rule released last week, CMS detailed
accreditation requirements for DMEPOS suppliers and the application
process for accrediting organizations, laying the groundwork for
competitive bidding.

But according to accreditation expert Mary Ellen Conway,
president of Capital Healthcare Group, Bethesda, Md., the rule
answers few questions that are on providers’ minds. “It gives us
more confusion and doesn’t say anything. Everything in the rule
comes from previous regulations,” she noted.

Medicare’s DME bid is slated to begin in 10 of the country’s
largest metropolitan areas next year and expand to 80 areas in
2009. Suppliers that plan on participating in the bid will need to
be accredited by early 2007, the rule said. CMS also said it plans
to use Competitive Bidding Implementation Contractors to help
implement the program.

However, the agency has yet to finalize its supplier quality
standards–which HME providers must meet not only to participate in
the bid but also to do any Part B business–or approve the
accreditors that will apply them. CMS said the standards would be
published in the “near future,” and that it expects to approve
several accrediting bodies in order to meet the bidding dates. The
agency said it will request those accreditors to prioritize their
surveys to assist suppliers located in the bidding areas for
2007–but those 10 areas also have not been named.

In the document released Wednesday, the agency said it
“recognizes that becoming accredited imposes a burden on suppliers
and has attempted to minimize the burden” by taking the following
actions:

1. Accreditation organization selection–“We expect to select
   several accreditation organizations, which will induce competition
   and assist in decreasing accreditation costs.”
2. Plan for small businesses–“During the application process we
   will ask accreditation organizations to include a plan that
   outlines their methodology to reduce accreditation fees for
   small/specialty suppliers and suppliers that have multiple
   locations.”
3. Application of streamlined quality standards–“We will
   encourage accreditation organizations not to expand on streamlined
   quality standards.”
4. Streamlined processes–“We have clarified in the final rule
   that the role of the accreditation organizations is to ensure
   compliance with the quality standards and that accreditation should
   not be contingent on using consultation services or purchasing
   manuals.”
5. Unannounced survey process–“Utilizing an unannounced survey
   process reduces ‘ramp-up’ costs and survey preparation time.”

But Conway said many of these actions are not helpful. “There
are already several accreditation organizations in competition.
There’s nothing new about that,” she pointed out.

Using consultation services and purchasing manuals are already
optional, Conway continued. Furthermore, she said she does not
understand how unannounced surveys would reduce costs. “Providers
are still going to have to do the same things and spend the same
amount of money to prepare regardless of whether a survey is
announced or unannounced,” she said.

CMS said it received approximately 600 comments on the proposed
rule, many of which are listed in the final rule, and said it is
planning an education campaign about the bidding process, including
special bidders conferences, for beneficiaries, referral sources
and suppliers.

To view the final rule, click here. The section on accreditation begins
on page 131.