Flash Inspections Jeopardize Accreditation Process, Attorney Warns

HIALEAH, Fla.–According to Florida health care attorney Javier
Talamo, some HME companies seeking accreditation are being given
“cursory” inspections that could undermine the integrity of the
process.

Although he did not name the accrediting organizations involved,
Talamo, of law firm Kravitz & Talamo, said he had been informed
that some of the surveys lasted only 20 to 40 minutes.

“It is grossly unfair to have some companies subjected to
rigorous two-day inspections while others are given a free pass. I
understand that accreditation is a business, but it must be
conducted in an ethical manner,” Talamo said.

Tom Cesar, president of the Accreditation Commission for Health
Care–one of CMS’ approved DMEPOS accrediting bodies–confirmed
that he believes inspections of that brevity are taking place.
“There’s someone out there that, as I understand it, is spending a
short amount of time looking at things and then moving on,” he
said.

Cesar said he understood CMS had been informed of the situation,
but at press time, the agency had not responded to HomeCare
Monday’s request for comment.

Late last year, CMS named 11 accrediting organizations to
enforce its supplier quality standards and gave them “deeming
authority” to accredit HME providers. Two of the accreditors merged
in January, leaving 10 on the list. (See
HomeCare Monday, Jan. 22.)

Under the agency’s competitive bidding program, providers
participating in the 10 initial bidding areas must be accredited by
Oct. 31 in order to be selected for Medicare contracts. And at some
point as mandated by the Medicare Modernization Act–although CMS
has not yet set a deadline–all providers who wish to do Medicare
business must be accredited.

“If CMS is to impose mandatory accreditation, it must monitor
its AO’s and it must ascertain that patient care is not being
compromised,” Talamo said, adding that “if we do not protect the
accreditation process, it will soon become irrelevant.”

A HomeCare comparison of four industry accreditors
existing in 2005 showed that all four typically spent at least one
day on a survey for a small, single-location HME. The report showed
the inspections could run even longer depending on the size and
complexity of the operation. (See
“Thinking About Accreditation,” HomeCare, October
2005.)

While some accreditors say they have streamlined internal
processes to help providers comply with CMS’ bidding timeline, the
time it takes to complete onsite surveys isn’t one of them.

Raul Lopez of Bayshore Dura Medical in Miami Lakes, Fla., and
president of the Florida Association of Medical Equipment
Suppliers, said the association had heard rumors of short
inspections, but “most of the FAMES members who have given us
feedback are telling us [their surveys] are just as strict” as
ever. Lopez said he had also heard promises of speedy
accreditations, like a “we can get you accredited in three weeks
type of thing … but what they’re doing to fast-pace it, I don’t
know.”

Others in the industry said they also had heard talk of the
flash inspections.

Accreditation consultant Mary Ellen Conway, president of Capital
Healthcare Group, Bethesda, Md., said she had heard rumors about
brief surveys, though she didn’t know who was conducting them.
“People have to step up and say who the providers are that are
getting the free pass and who’s giving it to them,” Conway said.
“It diminishes the process for all.”

Walt Gorski, vice president, government affairs, for the
American Association for Homecare, shared a similar sentiment.

“We believe that the accrediting organizations must fulfill
their responsibilities to do the job they were tasked with,” Gorski
said. “If any of these allegations are true, it undermines the
whole process.”

According to Conway, it can take from four to six months for an
HME company to prepare for an accreditation survey. “One-day
surveys are really tough when there’s any home business involved,
so I don’t know how anybody could do a 40-minute visit and have the
information validated,” said Conway. “It just doesn’t make sense to
me.”

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