The whining started as soon as Senator Trent Lott (R-Miss) introduced his proposal that all HME providers be accredited as part of the Senate Finance Committee’s Medicare reform and prescription drug bill. Catcalls of “it’s too

expensive” or “accreditation doesn’t mean anything” could be heard from every corner. It seemed that a lot of providers forgot that, for many years, the industry has internally discussed encouraging Congress to enact legislation making accreditation mandatory. However, more pressing issues, such as opposing competitive bidding, had always taken priority and consumed limited lobbying resources.

Now, truth be told, the vast majority of small companies in the industry have not devoted the necessary efforts to becoming accredited. Pursuing accreditation takes significant human and financial resources that simply are not available while coping with multi-year price freezes or preparing for the possibility of a competitive bidding environment.

Nonetheless, the gauntlet has been thrown. It is not a done deal because, at press time, the whole Medicare bill was facing an uphill battle on a number of fronts unrelated to the HME industry. However, industry opposition to accreditation would, at least in Capitol Hill terms, be akin to saying that the industry does not support quality HME services being provided to the nation’s seniors.

While many will justly debate the merits of that statement, the fact is that in Washington, DC, members of Congress perceive opposition to mandatory accreditation as supporting fraud and abuse. And there is some measure of truth to that perception. If you look at the few scam artists that have polluted our industry’s image, you would probably find that few, if any, of these entities were accredited. Therefore, if an HME supplier had to be accredited to submit a claim to the Medicare program on behalf of a beneficiary, the majority, if not all, of the scam artists would be unable to commit the fraudulent acts that haunt this industry.

The HME industry constantly talks the talk about elevating its image and/or demonstrating to legislators and regulators that its services result in an improved quality of life for Medicare beneficiaries. Senator Lott’s challenge to the industry requires that providers begin to walk the talk.

Accreditation is essential to changing the perception that HME providers are just “delivery boys” that drop off various pieces of medical equipment and supplies at the consumer’s door. Moreover, accreditation is the key to convincing legislators and regulators that the services provided are truly integral to the equipment delivered.

Yes, accreditation can be an expensive proposition, particularly for smaller providers. But, because the amount of competition in the accreditation niche has increased over the past few years, there are now less expensive options than the traditional accreditation organizations.

In addition, accreditation would provide leverage for the industry to use in other arguments. For starters, accreditation is a great argument supporting the reduction of some of the unnecessary and expensive paperwork Medicare currently requires HME providers to fill out, as well as for decreasing the number of postpayment audits. Plus, if all HME providers are accredited, one can make the case that they can be trusted with access to the common working file to obtain beneficiary eligibility and related information.

It is time for the industry to bite the bullet and put its money where its mouth is. The idea of requiring accreditation as a way to improve quality and reduce fraud has been articulated by industry representatives for years. Senator Lott and his colleagues just took the industry at its word. Thus, if the industry wants to be perceived as an important and credible component of the health care delivery system, it must stand up and collectively walk the talk in support of accreditation.

Cara C. Bachenheimer, JD, is a partner at the law firm Epstein, Becker & Green in Washington, DC. David T. Williams is director of government relations for Invacare, Elyria, Ohio.