Applications Still Short of Accreditors’ Expectations

ATLANTA–Despite CMS’ extension of the accreditation deadline
for HME providers wishing to participate in competitive bidding,
accreditation organizations still are not seeing a surge of
applicants, they told HomeCare last week.

On July 27, the previous deadline, CMS extended its bid window
to Sept. 25. It also extended the accreditation deadline from Aug.
31 to Oct. 31. Providers must be accredited to be awarded a
contract in the initial round of the bidding project.

“We’re not seeing a flurry of activity right now. I think that
individuals that [plan to bid] have already applied,” said Robert
Floro, R.R.T., newly promoted director of the home care
accreditation program for The Joint Commission.

Terry Duncombe, president and CEO of the Community Health
Accreditation Program, said phone calls regarding accreditation
escalated after the announcement of the deadline extension. But
overall, she said, “it hasn’t been the numbers that anyone thought.
We’ve had a fair amount of agencies already accredited. From
January 2007, we’ve had 80 organizations that have started the
process with us, probably 40 of them since April.”

Like other accreditors, however, CHAP was prepared to serve many
more applicants. “We’re poised to take on quite a bit more,”
Duncombe said. “We could without a doubt handle another 65 to 75
agencies.”

In announcing the bid program during an early April press
briefing, then-acting CMS Administrator Leslie Norwalk said the
agency had estimated “generally that we’ll have maybe 20,000 bids,
and about half of [those suppliers] would participate in this
program.” While CMS will not reveal how many bids it has received
so far, stakeholders have surmised that the numbers are far below
those anticipated.

Floro said he was not surprised that even after the deadline was
extended, few new organizations have applied for accreditation. “If
they weren’t ready a month ago, what makes anyone think that
organizations are going to be more ready for accreditation now?
They haven’t prepared to this point, so extending the deadline [is
not going to make much difference],” he said.

Both he and Duncombe said they had contacted previous applicants
who either tried to apply too late in the game or did not complete
the process before the initial deadline.

“We’ve already reached out to those we had to turn away,” Floro
said, adding that initially there was “a significant collection of
organizations” that applied for accreditation but did not complete
the application process.

While it might not result in significantly greater numbers of
applicants, Duncombe said the deadline extension could help cut
down on the number of deferrals. “As [providers] try to rush and
get ready [for onsite visits], we are seeing an increase in our
deferrals because they are not quite ready,” she said.

Mary Ellen Conway, president of Capital Healthcare Group,
Bethesda, Md., said the biggest help with the accreditation
extension “is that everyone who is trying to get a survey now can
do a better job on what they are pulling together.”

She said the extended deadline would likely eliminate “heavy,
expensive follow-up” because providers would have more time to
prepare. “It’s really intended to give people more time to do a
better job at what they are doing,” she said.

Conway did call the extension a “huge win” for those companies
who got their money back from accrediting organizations because
they had applied too late to meet the initial deadline. If they act
immediately, they can still be a part of competitive bidding, she
said.

Duncombe also cautioned that providers wishing to bid in the
first round can’t wait. “They need to do it now. If they are not in
our pipeline in the next 30 to 45 days, [the extension] is not
going to matter,” she said.

While accreditors are generally giving priority to providers in
the initial 10 CBAs, there is only so much latitude, they said.

“We have 1,500 organizations that need resurveying, as well,”
pointed out Floro, referring to those providers that are already
accredited but must be resurveyed in order to maintain their
status.

The accrediting bodies are also mindful that there could be an
onslaught of new applications next year. Not only will providers be
preparing for the second round of competitive bidding, but CMS is
expected to implement a requirement in the near future that all HME
providers be accredited.

Tom Derrick, director of public relations, marketing and
professional discipline for the American Board for Certification
for Orthotics, Prosthetics and Pedorthics, said his agency’s
applications in 2007 have tripled in number in comparison with
previous years. “We expect the pace to pick up even more in 2008,”
he said.

Floro noted that providers wishing to do business with Medicare
soon won’t have a choice. “CMS will announce the date shortly when
all the [HME providers] will have to be accredited. So it’s a
matter of do you do it now or do you do it later,” he
said.