Can transparency be so invisible that you can't actually see it? Far from laying its cards on the table, it seems that CMS is keeping many bits of information close to the vest these days. "Why is CMS so secretive?" asked Tim Pederson of WestMed Rehab, Rapid City, SD. "I feel like we need a security clearance just to get a straight answer from them."

Over at VGM, Mark J. Higley expressed similar sentiments. "I see no reason why at this point CMS can't announce the next 70 competitive bidding areas (CBAs), and announce the product categories," said Higley in a recent issue of Friday Report. "There need to be some general guidelines as to acceptable financial standards. Some providers in round one did not even bid because they were unclear with regard to what financial standards were required."

Instead of simply telling attendees the actual number of first round bidders at last month's Program Advisory and Oversight Committee (PAOC) meeting, CMS revealed the number of accredited companies from round one (2,200). From this figure, Higley crunched the numbers and came up with a logical estimate of 1,500.

And what about that drop-dead date for accreditation? At a recent open door forum, a CMS official coyly called one reasonable guess "not even close," but offered no hint at the actual date. I don't mean to demonize CMS, and I know they are merely implementing the law. However, transparency is definitely a bit cloudy these days in Washington.

Meanwhile, after another largely successful Medtrade in Orlando (opinions varied as usual), I could not again help but wonder how powerful it would have been to hold this event in Washington, DC (clouds and all). David T. Williams and Cara Bachenheimer mentioned this back in their December 2004 Our Turn column. I agreed with them a few months later in an editor's message, only to be rebuked by Medtrade organizers who essentially said, "Leave destination decisions to the professionals."

As I write this, Senate finance committee members are hammering out Medicare legislation with major implications for the industry. AAHomecare has an excellent yearly fly-in to DC, but they can't match Medtrade's 13,000-plus attendance. Wouldn't it be nice if Senate offices made these decisions after hearing 13,000 voices?

Greg Thompson

HMEtoday.com Resources If you have not yet had a chance, check out this value-added content only available online: Buyer's Guide: For a good list of many companies found at the recent Medtrade show in Orlando, search the database by company name or product category. Top News: Make HME Today your home page because all news is updated daily. To set up a free RSS feed of HME Today news to your site, contact us at . Expert Insight: With expert insight, you have access to real and trusted experts who answer your questions for free. Sandra C. Canally, RN, president of The Compliance Team Inc (accreditation), is available now to answer your questions.