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.