If You Service Hospices, You’ve Got a New Accreditation Deadline

ATLANTA–In a disconcerting surprise to many home medical equipment
providers, those that service hospices must be accredited by Dec.
2, 2008, in order to keep their contracts, according to the
finalized “Conditions of Payment” for Medicare and
Medicaid hospices published recently in the Federal Register.

The COP, published June 5 and effective Dec. 2, stipulates that a
hospice may only contract with a durable medical equipment
suppplier that meets the Medicare DMEPOS Supplier Quality and
Accreditation Standards at 42 CFR 424.57.”

That standard, noted in the special payment rules for items
furnished by DMEPOS suppliers, defines accredited DMEPOS suppliers
as “suppliers that have been accredited by a recognized
independent accreditation organization approved by [the Centers for
Medicare and Medicaid Services] in accordance with the requirements
at Sec. 424.58 [of the “Conditions for Medicare
Payment” for DMEPOS providers].

News of the accreditation requirement, which has dribbled out as
hospices have alerted their HME suppliers, has panicked some
providers, according to accreditation consultant Mary Ellen Conway,
president of Capital Healthcare Group, Bethesda, Md.

“We’ve been getting tons of calls from people being
contacted by hospices saying they have to be accredited,”
Conway said. “I’m concerned about the number of people
who have called to clarify the information and find out what they
need to do to get started now.”

While some providers serving hospices are already accredited, many
were shooting for the Sept. 30, 2009, mandatory accreditation
deadline set for all DMEPOS providers by CMS last year. But under
the new rule, for providers contracting with hospices, that
deadline will not work.

“For a DME that has hospice as … a major portion of
their revenue stream, this is an enormous requirement,”
Conway said. “It’s fine if a provider is already
accredited, but based on the number of calls we’ve gotten, it
could be a problem.” State hospice surveyors, she added,
“are going to be looking for that requirement of only dealing
with accredited providers by that Dec. 2 date.”

Bob Floro, MSL, RRT, director of the home care accreditation
program for The Joint Commission in Washington, D.C., said his
accrediting organization has already gotten calls from providers
seeking accreditation in order to service hospices.

“I just fast-tracked somebody last night,” he said,
adding that he expects calls to increase as more and more hospices
communicate the new standard to their HME providers.

Floro said it is possible for his organization to accredit a
provider by the Dec. 2 deadline.

“It’s doable. There’s a very, very tight window.
The surveys have to be done by October or maybe the first week in
November to meet the deadline,” he said. However, he pointed
out, it’s only doable if a provider understands the level of
preparation it takes to become accredited and accomplishes that in
two months.

Gwen Franzgrote, director of HME services for the Washington,
D.C.-based Community Health Accreditation Program, said she has
also received inquiries about DME accreditation to supply
hospices.

“For those that are starting now, it is possible to get
through the process,” she said, “but I would not
encourage them to wait much longer.”

Hospices will want to be found in compliance by that Dec. 2 date,
she stressed. They are thus unlikely to continue their association
with HME providers who are not accredited.

Tom Caesar, president of the Raleigh, N.C.-based Accreditation
Commission for Health Care, said his organization has so far
received just a few e-mails on the accreditation issue. He is
doubtful that ACHC would be able to accommodate any but the most
prepared of providers applying now for accreditation by Dec.
2.

“We are scheduling 400 surveys right now,” he said, so
the organization’s priority is to those providers already in
the pipeline for accreditation. HME providers shooting for the Dec.
2 deadline, he said, “have to be ready like now, and then we can put them on as
quickly as possible.”

He pointed out the probability that this won’t be the only
accreditation deadline to pre-date the CMS mandatory deadline. Some
state Medicaid agenicies are considering or have already
established their own accreditation deadlines, both he and Conway
said. Conway also noted the Jan. 1, 2009, accreditation deadline
“that is sneaking up fast” for providers who were
enrolled with the National Supplier Clearinghouse before March 1,
2008. (Providers who enrolled on or after March 1 must already be
accredited.)

“Frankly, for the folks who do DME Part B, a lof of them have
waited and waited and waited to get accredited. And it’s
going to work against them,” Caesar said.“The guys in
the DME world might as well get accredited.”

To
view the final rule for hospices, click here and scroll to section 32212 (page
126 of the PDF) for 418.106 “Condition of participation: Drugs and
biologicals, medical supplies, and durable medical
equipment.”