AAHomecare: Accreditation Exemptions are Risky Business

ARLINGTON, Va.–Exempting physicians and others who provide home
medical equipment from accreditation could affect quality of care
and eliminate a valuable tool to fight fraud and abuse, according
to the American Association for Homecare.

Last week the organization came out in opposition to CMS’
decision to exempt certain DMEPOS providers from Medicare’s
Sept. 30, 2009, mandatory accreditation deadline.

“Accreditation helps to ensure that patients receive
high-quality home care, and it is also an important tool in
preventing fraud in the Medicare program,” said Tyler Wilson,
AAHomecare president and CEO.

The announcement came in response to a Sept. 3 Open Door Forum
in which CMS’ Sandra Bastinelli said mandatory accreditation
does not apply to those the agency considers “eligible
professionals.” That list includes physicians, PTs and OTs,
qualified speech-language pathologists and practitioners, physician
assistants, certified registered nurse anesthetists and clinical
social workers, among others. (See HomeCare Monday, Sept. 8.)

While physicians on the call sent “hugs and kisses”
to CMS for exempting them, AAHomecare questioned the wisdom of such
exemptions.

“We really believe that accreditation and supplier
standards should apply to all [who provide HME],” said Walt
Gorski, AAHomecare’s vice president, government affairs.
“AAHomecare believes that if you are going to provide and
bill for DMEPOS items, there should be no exceptions to the
accreditation requirements.”

Under the Medicare Improvements for Patients and Providers Act,
which established the exemptions, orthotists and prosthetists are
also currently exempt from the accreditation deadline, but CMS
plans to publish a notice of proposed rulemaking in 2009 that will
address quality standards for those providers.

Gorski said AAHomecare champions both accreditation and quality
standards for HME providers of all stripes.

“Quality standards and accreditation are aimed at
improving quality of care,” he said, adding that both are
effective tools to fight fraud and abuse.

“Not only do we want to make sure quality is maintained
and improved, but we want to make sure that only legitimate
suppliers bill and provide DMEPOS items,” Gorski said.
“We thought that a third-party check (accreditation) to
verify a provider’s status was legitimate. It was good to move
forward with.”

While the quality standards are a move in the right direction,
Gorski has reservations about the final version of the standards,
which could be released next month.

“The quality standards have been finalized and are under
final review by the administrator,” he said. “CMS has
indicated that the final quality standards could be published in
October.”

There are numerous issues with the proposed quality standards,
however, and he is unsure how those will be addressed, Gorski
noted.

“We are hopeful that ultimately CMS will revise the quality
standards so that all suppliers compete on a level playing field to
ensure that patients are receiving the highest quality of care
possible,” he said.