We are all familiar with the competitive bidding controversy in the HME industry, but despite the recent delay, accreditation is not something to take lightly. Each state may have its own requirements and regulations, and from a business standpoint, accreditation can help you run your operation. "It's a value-added process, not a burden," says Thedford Jones, Jr, president, CEO, and cofounder of The Intelligent Business Network Inc in Burbank, Calif.

With the delay in competitive bidding, Jones fears that HME suppliers will say, "‘I don't need to do this. I'm putting it on the back burner.'" The best thing to do, he believes, is to put your patients first and ingrain accreditation into your organization so you don't have to think about it later. "It will be one thing you can put behind you," he notes.

In the HME industry, accreditation really should be mandatory, says Mary Ellen Conway, president, Capital Healthcare Group LLC, in Bethesda, Md. "Any supplier that provides equipment and services [not just to Medicare beneficiaries] should become accredited," she says. Voluntary accreditation has been available for some time through independent organizations. Suppliers who comply with the quality standards can retain their supplier numbers and receive payments.

"It is difficult to maintain," Jones adds. "There are new standards that people have never dealt with before [with respect to CMS, Medicare, and competitive bidding]."

Along with getting accustomed to the forms and paperwork, Jones urges providers to make sure new hires get the proper orientation. "Continue to monitor your employees' competence and evaluate your patients. Are they receiving the best care possible? And look at your claims data," he explains. "Ask why you are getting denied and ask whether you can implement performance improvement practices/ measures to reduce denials in the future."

If providers decide not to become accredited, they will be walking away from Medicare business. However, many other payors model themselves after the Medicare program. You may already be working with networks or third-party payors that require accreditation. Check with your payors and networks first to see if you are limited to certain accreditors.

A major goal of accreditation should be to increase the standards that all providers must meet. There is nothing wrong with being in compliance with quality standards. As Conway puts it, accreditation helps reduce fraud and abuse in the industry. Once you are accredited, you should realize operational efficiencies and be on a more level playing field with your competitors. It's also a way of distinguishing legitimate businesses from fraudulent ones, and activists say our industry should support accreditation and quality standards in an effort to prevent businesses that are not in compliance from operating.

ATTACKING THE PROCESS

Accreditation can be a lengthy process, taking an average of 9 to 12 months, and longer in some cases. It takes preparation, but if your goal is to make the September 30, 2009 deadline for accreditation, you have to start early. Be aware that surveyors can become overwhelmed. In general, "If you're in health care, you need to adopt quality standards to make sure your business is following the rules/regulations and business practices to stay out of trouble," Jones says.

Ted Jones	Mary Ellen Conway

When preparing to become accredited, Conway says companies should pay attention to the performance management aspects of the business, especially patient satisfaction. "Patient surveys, complaint logs, service logs, and error logs are key measurements," she says.

Accreditation is an effective way to demonstrate your dedication to providing quality services, Con­way stresses. It's a certification of your business's compliance with state and federal laws and regulations.

CHOOSING AN ACCREDITOR

Make sure your line of business is relevant to the accreditation company you're looking at. You want to have the ability to meet the requirements without having to hire staff just to maintain your accreditation. Think about how long the accreditation applies (1, 2, or 3 years) and what, if anything, are the requirements for in-between years.

Clear away your misconceptions and realize that:

• accreditation is not just a seal of approval—it's an incentive to improve;
• accreditation should make you feel good that you operate in a professional manner;
• the industry needs you to be accredited;
• accreditation gives employees the tools to do their jobs better;
• accreditation can keep your job challenging, and make you excited about your work;
• the process can be just what your organization needs to make changes;
• accreditation can represent a higher level of quality required by any state;
• accreditation is a process and not a one-time thing. It shows a commitment to the industry.

COMP BIDDING STATUS

The House voted to eliminate a 10% payment reduction for Medicare physicians, and postpone the DME competitive bidding program that ultimately went into effect (briefly) on July 1, 2008. On June 27, the Senate came one vote shy of ending debate on the House-passed Medicare bill (HR 6331) that included a repeal of competitive bidding. Sixty votes were needed to invoke "cloture" to bring the debate to a quick end. After Congress came back from the July 4 holiday, the legislation came up again, and with it successful passage that included the 18- to 24-month delay.

Regardless of the delay, retailers and suppliers will ultimately need to meet quality standards that CMS has established, as well as receive accreditation from one of 10 organizations chosen by Medicare. Any retailer, in fact, that wishes to sell DME equipment will have to submit a bid to CMS, stating at what price it is willing to sell the products.

Nina Silberstein is a contributing writer for HME Today.