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.