Accreditors: Still Time for Providers to Meet CMS Deadline

ATLANTA–With CMS’ announcement last week that providers who
want to participate in the first round of competitive biding must
be accredited by Aug. 31, DMEPOS accreditors say there’s still
time–but those providers will have to hurry.

CMS had previously stipulated that in order to submit a bid,
providers must be accredited or pending accreditation. According to
a CMS timeline, bidding will open late this month with a bid window
of 60 days.

Industry consultant Mary Ellen Conway, president of Capital
Healthcare Group, Bethesda, Md., said she was surprised at how
early the deadline had been set.

“I thought we were told [providers] had to be in process and
that was going to mean they had up until the time the bids were
going to be awarded,” she said. “Now it’s just a tighter timeframe
… people need to get moving and need to get it done.”

Industry consultant Roberta Domos, president of Domos HME
Consulting Group in Redmond, Wash., agreed that it would be “down
to the wire” even if providers get started right now.

“I think it’s going to be very tight,” Domos said. “If they plan
to bid, they’re really under the gun right now. If you’re in a
competitive bidding area and you want to bid, you need to get
started yesterday.”

Conway said providers need to notify their accreditation
organizations no later than mid-July to schedule a survey in order
to have it completed by Aug. 31.

“That means they have to spend all of May and June and maybe two
weeks into July–that’s 10 weeks–getting everything done to be
ready for a survey to be scheduled,” she said. “That’s a really
short amount of time. The message is it’s going to be a really
tough next couple of months.”

Eight of the 10 CMS-approved accreditation organizations that
had responded to HomeCare Monday by press time said they
thought providers would still have enough time to make the deadline
(see
below). Some said that could change, however, if they receive a
flood of applications.

Meanwhile, in a “Special Edition MLN Matters” article
accompanying the deadline announcement, CMS estimated that 5,000
suppliers are accredited, that 329 of them are in the 20 MSAs
originally targeted as potential bidding sites and that 1,000
surveys have been scheduled since the start of 2007.

Some accreditors expressed no sympathy for providers who have
waited to become accredited and have not at least taken steps to
prepare, such as comparing accrediting organizations or putting
together policy and procedure manuals. Back in 2003, one pointed
out, the Medicare Modernization Act required that providers who
bill Medicare for identified Part B products and supplies become
accredited.

But Domos noted that there was a lot of talk surrounding last
year’s Hobson-Tanner bill, legislation that would have eased some
of competitive bidding’s effects, and that many providers may have
been expecting “some kind of a white knight” to come in and change
things. “There might have been a perception that the deadline they
were going to get was going to be a little bit longer,” she
said.

Still, some providers said they see no reason to spend money
becoming accredited when they might not be able to win business in
the competitive bidding marketplace anyway. Indeed, in its draft
rule issued in May 2006, CMS said it expected there would be 50
percent fewer DMEPOS providers doing business with Medicare than
currently exist after implementation of the bidding program.

“Why cough up the money if you know you’re going to be killed
off in the fight?” one oxygen provider told HomeCare
Monday, comparing the situation to a “kamikaze flight.”

“Who cares if you have a hole in your underwear [if] you’re
about to fly your plane into the ground?” the provider asked. “It
will cost me about $15,000 to get accredited. If I gain nothing
from this other than more piles of paperwork, why would I spend the
money?”

HomeCare Monday CMS’ 10
deemed accrediting organizations with the question: If
providers apply for accreditation now (or within the next few
weeks), will they be able to complete the process by Aug. 31?
Comments from those that responded follow: contacted

Accreditation Commission for Health Care:
“As of today, the answer is yes … Our assumption is, if they can
get everything we need to us within the next three to four weeks,
we think we can easily get them in that deadline. If they’re trying
to wait over a four- or five-week period before they send, that’s
really going to [create a crunch time] … Right now we feel pretty
comfortable they can be surveyed before those dates.”
–Tim Safley, HME clinical advisor

American Board for Certification in Orthotics,
Prosthetics & Pedorthics:
“In the MSAs identified by CMS, ABC should be able to complete the
site visit by Aug. 31 if the organizations apply within the next
couple of weeks. If there are no deficiencies found, then an
accreditation award should be able to be issued by Aug. 31 as
well.”
–D. Scott Williamson Jr., director of facility accreditation and
information services

Commission on Accreditation of Rehabilitation
Facilities:
“As far as we are concerned, anyone who applies by the end of June
will be accredited by the end of August … come the end of June,
everyone is going to get deluged … I wouldn’t encourage anyone to
wait.”
–Darren Lehrfeld, chief accreditation officer and general
counsel

The Compliance Team:
“Yes … it is expected that they will be able to meet the Aug. 31
deadline. In fact, we tell newly enrolled participants from the 10
[competitive bidding areas] that given CMS’ deadline, they need to
treat the implementation of our program as if it were a fire drill,
only now it is a fire drill with their hair on fire.”
–Sandra Canally, president and founder

Healthcare Quality Association on
Accreditation:
“Yes, today it appears possible. The closer the deadline draws
near, the more of a backlog there will appear.”
–Mary Nicholas, executive director

The Joint Commission:
“If they can apply today, get ready in four months and we can
survey them sometime in July, then the possibility exists. But it’s
a very tight timeframe … If we have 1,000 applications received
in the next couple of weeks, they will not be surveyed before Aug.
31, I can tell you.”
–Bob Floro, senior associate director for the home care
program

National Association of Boards of
Pharmacy:
“Providers that apply now, or within the next few weeks, unless
there are significant deficiencies in their application or
processes, will be able to be accredited by Aug. 31, 2007.”
–Carmen Catizone, executive director

National Board of Accreditation for Orthotic
Suppliers:
“Our accreditation is largely for orthotics. Some of those provider
types–physicians, therapists, orthotists–are not going to be
faced with competitive bidding right now. So those providers are
not on as stringent a timetable as [DMEPOS] providers. I think,
though, that NBAOS is in a position where they could get a facility
accredited by August.”
–Nancy Cannon, member, board of directors

To download the Special Edition MLN Matters article on this
topic, go to http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0713.pdf.

For a list of CMS’ 10 approved accreditation organizations for
DMEPOS suppliers, click here.

For providers attending Medtrade Spring, representatives from
eight of the accrediting organizations will be exhibiting at
Accreditation Central.