HME Today: Should providers who know they will not be in the first 10 metropolitan statistical areas (MSAs for competitive bidding) bother to get accredited in 2007? If so, why?

Sandra C. Canally

Sandra C. Canally, RN, president, The Compliance Team Inc, Spring House, Pa: Yes. CMS has already indicated that there are 100,000+ DMEPOS providers who will need to be accredited over the next 3 years, and there is nothing coming from Congress or CMS that tells us that mandatory accreditation is going to magically go away. By getting started now, providers who are not in the first 10 MSAs will be able to pursue accreditation at a pace that they will be able to control much better than those that wait until the last minute. If providers who are not in the first 10 MSAs choose the Compliance Team, they will be able to take a more leisurely pace with us as we give them the individual attention that we are noted for.

Robert J. Floro

Robert J. Floro, RRT, senior associate director, Home Care Accreditation Program, Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Oakbrook Terrace, IL: In addition to the mandatory accreditation requirement for competitive bidding, the MMA of 2003 requires that all DMEPOS providers must meet the CMS Quality Standards through accreditation. They have not set the due date for this requirement, but organizations that contemplate continuing to serve Medicare beneficiaries must eventually become accredited—regardless of the geographical areas they serve. More importantly, accreditation improves the quality and safety of your services. Improvement in these areas must always be the primary motivating factor that drives accreditation.

Timothy L. Safley

Timothy L. Safley, MBA, RRT, RCP, HME clinical advisor, Accreditation Commission for Health Care (ACHC), Raleigh, NC: Since the inception of the competitive bidding rule, there has been little doubt that if companies bill Medicare Part B, they will have to be accredited. The timing for companies that are not in the original 10 MSAs is still under some speculation. ACHC still believes that each HME company needs to, at a minimum, start the accreditation process. For small providers, this process is just educating themselves to understand what is required.

I recommend that all providers spend time learning what the accreditation process is for the types of service that are offered by their businesses. If there is no concern for the initial 10 MSAs, take several months to research the accreditation agency that offers the best fit for your type of business (that is given to the Medicare Part B beneficiary.

HME Today: In general, how have accreditations been going after publication of the final standards?

Canally (The Compliance Team): Enrollment in the Compliance Team's Exemplary Provider™ Accreditation Program for DMEPOS has steadily increased since CMS came out with its final quality standards last August. Our enrollment really jumped after CMS announced in November that we were one of the approved DMEPOS accrediting bodies. Despite that good news, the enrollment jump has not been as much as we expected—which I believe all of the accrediting bodies are experiencing.

Floro (JCAHO): The number of applicant organizations has almost tripled since CMS issued final quality standards last August. The unfortunate issue is that so many more are waiting to see if they supply those equipment types that will be competitively bid within the 10 selected MSAs for 2007. As accreditors gear up for the increased applications, they are predicting a certain percent of the accreditation market share based on known metrics within the MSAs. If those applications are not received in time, or organizations allow inadequate time to effectively prepare—or the accreditors have difficulty in scheduling within their capacities—there may be some organizations that will be excluded from the 2007 competitive bidding process because they waited too long.

Safley (ACHC): There has been a slight increase in applications since the original ruling about mandatory accreditation. However, the increase has been slight, and that appears to be due in part to the delay in the CMS time frame for accreditation. I believe that as soon as the announcement is made for the first 10 MSAs—and the follow-up with the next 80 MSAs—there will be a substantial increase in applications for accreditation.

HME Today: What do you say to providers who believe that accreditation is too expensive?

Canally (The Compliance Team): It is not expensive if they choose an accreditation that includes everything. The Compliance Team's Exemplary Provider™ Accreditation Program is a CMS-approved program that does that. When providers enroll, we send a preparation CD that includes a comprehensive set of service and product line-specific checklists, as well as examples (in MS Word) of all required written documentation. Along with the nonexclusive copyright to use those documents, providers are also guided through our implementation process by way of a series of orientation teleconferences that are conducted by our own accreditation advisors. There is no need to buy a Policy and Procedure Manual or hire a consultant.

For more information and articles on accreditation, visit the free online archives section. Additional articles can be found in February 2007, March 2006, October 2005, and June 2005.

Safley (ACHC): The increase is a little more than $1,300 per year, which does not include costs for getting ready and ongoing monitoring. The expense has become a cost of doing business so that payors can monitor care and also monitor fraud and abuse. Although this is a non-revenue-producing process, it adds value.

Floro (JCAHO): The value of accreditation is found in: improved patient safety; improved services; meeting some state licensure requirements; reduced risk and exposure; improved marketing/sales opportunities; and improved access to third party payors. Organizations must consider the entire scope of benefits and not just view accreditation as an access ticket to Medicare. CMS is moving the industry toward accreditation. When standards are embraced by the industry, we will establish ourselves as a highly professional component of health care. The improvement in the professional perception of our industry is certainly worth the cost.