Accreditation Call Ends with Testy Exchange over Round Two Zip Codes

BALTIMORE–Despite recent calls for more and better
understanding from both CMS and those working in HME, an
accreditation teleconference last week proved that both sides have
a way to go.

Thursday’s dial-in, one of a series from CMS on mandatory
accreditation, began in the expected way. An initial presentation
repeated deadlines and urged providers to start the process.
(Suppliers who want to participate in round two of competitive
bidding must apply for accreditation by May 14 this year, and all
Medicare DMEPOS suppliers must be accredited by Sept. 30,
2009.)

But when a California pharmacy owner called in to ask when CMS
planned to release the zip codes for the round two MSAs, it became
obvious that CMS was talking apples and HME was speaking
oranges.

“The reason I ask,” the caller explained, “is because the
MSA … that I am looking at is defined as Los Angeles-Long
Beach-Santa Ana, and there’s several pharmacies that are just north
of that by about 20 or 30 miles and they are all under the
impression that, because their city was not listed in the MSA’s
description, that they’re not a part of it and they don’t have to
worry about [accreditation] until Sept. 30, 2009.

“My concern is that they are a part of it,” the caller
continued. “I know for myself I was also in the Ontario MSA, and
that was defined as ‘Ontario-Riverside’ but it also extends out to
Palm Springs, which is basically 50 miles east of those cities
… I think it’s important that we know the zip codes of the
next MSAs so we know whether we need to be getting the ball rolling
or not … I’m just terrified.”

Sandra Bastinelli, director of the Division of Medical Review
& Education for CMS’ Program Integrity Group, answered that
“the folks that have oversight of the competitive bidding
process said in December that the zip codes were going to be
announced in May. That hasn’t changed.”

She also offered this observation:

“Having fear and not going forth with the accreditation
process is not a good business decision. We said that in round one,
and it’s 70 percent more of a bad decision in round two because
there are 70 percent more of you trying to get in for competitive
bidding in round two. So if you’re waiting to see if you are in
that zip code for round two, that’s a bad business decision …
because you will be scrunched to the end of the all-supplier
deadline.”

That began a testy exchange about whether CMS has properly
outlined the round two MSAs so providers would know whether they
need to meet the May 14 deadline.

Caller: “So even if they don’t define the MSA by zip code
…”

Interrupted Bastinelli: “The MSAs have been defined, so
you already know the MSAs.”

Caller: “No, we don’t.”

Bastinelli: “Yes, you do. The 70 MSAs are listed on the
CMS Web site.”

Caller: “Then let me ask you this question: Is the city of
La Habra included in the Los Angeles-Long Beach-Santa Ana MSA? It
says ‘Los Angeles-Long Beach-Santa Ana.’ It doesn’t tell us whether
the surrounding cities are included or not. And when we called the
help desk to ask if La Habra is included in that MSA, they didn’t
know.”

Bastinelli: “We’re out of time, and we have gone off
course of our intended topic, which was accreditation.”

Caller: “This has everything to do with accreditation, though.
We need to know whether or not we need to step up …”

Interrupted Bastinelli: “I keep telling you not to wait.”

The verbal fisticuffs ended there, but CMS was not the only one
suffering from a communications breakdown. One provider called in
and asked the following question:

“What is accreditation? And do I need it?”

To hear the complete replay of Thursday’s
teleconference, which will be available until 11:59 p.m. ET on
April 24, call 800/642-1687 and use passcode 39283514. To view CMS’
accreditation presentation.

CMS will conduct another accreditation teleconference Tuesday,
April 22 (tomorrow) for physicians and rehab providers.
Registration for the call closes at 1:00 p.m. ET today at www2.eventsvc.com/palmettogba/042208.

Officials said there is the potential for another call in
May.