CMS to HMEs: No Deadlines Yet, but Get Accredited Now

BALTIMORE–In what turned out to be only a blip on the
accreditation radar, CMS has rescinded a change request that gave
an April 2 implementation date for Part B providers to be
accredited in order to maintain their supplier numbers and bill
Medicare.

Issued on Friday, Jan. 26, then withdrawn on Monday, Jan. 29,
the transmittal was sent in error, the agency said. In a note to
contractors, CMS said, “Transmittal 188 is rescinded and will not
be replaced at this time … We apologize for any inconvenience
this may have caused.”

But Tuesday afternoon at an Open Door Forum, agency officials
once again urged DMEPOS providers to get accredited, and said they
were alarmed by the small number of providers they believe have
begun the process.

CMS’ Joel Kaiser said the agency had expected “a flow of
suppliers to get their accreditation” after approved accrediting
organizations were named in November, but instead had seen only “a
trickle.” Kaiser, deputy director of DMEPOS policy in CMS’ Center
for Medicare Management, said the agency’s goal is to have
suppliers accredited for the first round of competitive bidding,
slated for 10 yet-to-be-named metro areas this year.

At the forum, officials repeated that no specific accreditation
deadlines have been set. At a meeting in mid-December, however, CMS
told accrediting organizations that suppliers who want to bid in
2007 should be accredited by spring, and that those who want to bid
in 2009–when the program expands to 80 cities–should be
accredited by spring 2008. After that, Kaiser said at the Open
Door, additional bidding areas will be chosen “at the
administration’s discretion” and, at some point, all Part B
providers will have to be accredited in order to do business with
Medicare.

“My recommendation is that everyone should get accredited no
matter what size area they are in, and they should start the
process now,” Kaiser said, noting that even the second round of
bidding is “just around the corner.”

Because CMS has not published its final rule on competitive
bidding, required under the Medicare Modernization Act, providers
don’t know exactly which 10 cities will be selected as the first
bidding locations or which products will be included. But Kaiser
said the agency’s draft rule, issued last May, explained the
methodology it will use to choose those cities.

“We also know the law requires accreditation,” Kaiser said. “If
you are waiting for the final rule it’s probably not that good an
idea,” he continued. “We recognize there is a cost associated with
accreditation, but there is also a business risk associated with
not being accredited.”

Kaiser said CMS aims to have companies accredited before they
enter into a competitive bidding contract, but that providers would
not be barred from bidding if they are not yet accredited. He said
the MMA said that supplier quality standards–which providers must
meet in order to get accredited–should not delay the start of
bidding.

The explanation confused some listeners once again.

“Did I hear correctly that suppliers do not have to be
accredited before they submit bids, at least for this first round?”
questioned one phone caller.

“We can’t really give full details on what’s going to be
required in terms of who is eligible for entering into a contract
for competitive bidding,” came the response. “There are certain
parts of the statute that allow us to start the bidding and proceed
with the program. We definitely want our contract suppliers to be
accredited and [to meet] the quality standards. But whether or not
you need to be accredited prior to starting the bidding is not as
important.”

According to CMS’ Sandra Bastinelli, director of the Division of
Medical Review in the Office of Financial Management, the
accrediting organizations have “reached out” to providers,
particularly those in 2007’s possible bidding sites. But she said
four of the 10 deemed accrediting bodies reported they had no
suppliers accredited or “as little as 30.”

“The remark came back from suppliers that ‘We’re just waiting,’”
Bastinelli said. “We’re not sure what you’re waiting for,” she told
the Open Door audience. “No matter when that rule comes out you
have to be accredited … We don’t know how to make that more clear
than we already have.”

The caller apparently disagreed: “I think it’s a surprise that
you’re surprised that more people are not accredited because the
level of specificity about this program has been such that’s it’s
very difficult to recommend to anyone that they go ahead and get
accredited when they don’t know the final rules of the game.”

To view CMS’ proposed rule on competitive bidding click here.

To view the agency’s required supplier quality standards,
click here.

For a list of CMS’ deemed accrediting organizations, click here.