Accreditation Hiccup: Pharmacies Holding Out

WASHINGTON — According to Kimberly Brandt, director of
CMS’ program integrity group, there are now 51,000 DMEPOS suppliers
accredited or with accreditation pending. Speaking at a recent
meeting of the Program Advisory and Oversight Committee, however,
Brandt singled out pharmacies as the largest group remaining
unaccredited.

Pharmacy groups — including the American Pharmacists
Association, National Association of Chain Drug Stores, National Community
Pharmacists Association and the National Alliance of State Pharmacy
Associations — have been pushing for an exemption,
arguing that pharmacists are the only licensed medical
professionals that must meet CMS’ accreditation requirements. (See
Bill
Would Exempt Pharmacists from Accreditation, Jan. 26.)

But CMS officials at the June 4 meeting, held to discuss the
restart of competitive bidding, said providers must be accredited
in order to bid. And whether they bid or not, providers who want to
continue serving Medicare beneficiaries must be accredited by the
Sept. 30 deadline.

“We’re talking thousands of pharmacies that have not been
accredited,” said meeting attendee Sandra Canally, president of
The
Compliance Team, one of CMS’ approved accrediting
organizations. “It’s questionable as to how many more companies the
accreditors can get into the loop at this point. With the
pharmacies waiting so long to apply, it’s a serious concern.”

CMS had suggested Jan. 31 as a soft deadline to apply for
accreditation in order for providers to get through the process
before the September cutoff.

But in a public comment period, William Popomaronis, vice
president of the National Community Pharmacists Association, said
small pharmacies need more time to meet the required quality
standards. Of the 24,000 independent pharmacies the NCPA
represents, he said, fewer than 10,000 have started the
accreditation process.

On a CMS accreditation teleconference earlier this year, several
pharmacists doing limited Medicare DMEPOS business said they can’t
justify the cost of accreditation and may simply drop that
business. (See Pharmacists
Grill CMS on Accreditation Call, Jan. 12.)

CMS has estimated more than 25,000 DMEPOS providers will exit
Medicare because of the combined costs of accreditation and the
agency’s surety
bond requirement.

Canally said the pharmacy situation is not the only
accreditation hiccup. In the new Round One, she pointed out, CMS
requires that subcontractors be accredited. A CMS official at the
PAOC meeting clarified that the accreditation requirement
encompasses “all subcontractors,” she said.

Canally noted documents distributed at the meeting identify the
Medicare services a subcontractor may perform under the supplier
standards as the purchase of inventory, delivery and instruction on
equipment and repair of rented equipment.

That means, for example, “if you have farmed out your repairs to
Joe’s Repair Service, then Joe’s Repair is going to have to be
evaluated for the standards that relate to repair,” she said.

Added Canally, “What people need to understand is unless their
subcontractors are accredited, it’s going to hold up the
accreditation of the main billing provider.”

View an accreditation overview from CMS.