Deadlines and Deliverables

For the past few summers, it seems that just when we were ready to have a quiet season and enjoy the sun, the outdoors, the mountains and beaches, a new surprise from CMS has popped up to bring us back to reality. This summer's wake-up call came in the form of news from Medicare-certified hospices.

The hospice community has been waiting for updates to the rules they follow, known as the “Conditions of Participation” or the “COP's”. The draft updates to the COP's were released over two years ago and then, this summer, those updates were published in final form in the Federal Register on June 5.

This update has many components that hospices need to incorporate, but one of the significant changes is found in a sentence that states: “Hospices may only contract for durable medical equipment services with a durable medical equipment supplier that meets the Medicare DMEPOS Supplier Quality and Accreditation Standards at 42 CFR § 424.57.” These rules become effective for hospices on Dec. 2, 2008.

Unfortunately, the DME community really wasn't aware of this requirement right away. Most hospices only began contacting their DME providers in late July. At that time, providers started calling our offices in a panic because their hospice contracts were in jeopardy since they had not yet become accredited.

As we researched this regulation, we found that it was, in fact, true. The news quickly spread, and during an Aug. 13 Open Door Forum, callers asked CMS staff about this new deadline and why it conflicted with the Sept. 30, 2009, deadline for mandatory DMEPOS accreditation. Staff members were at a loss to answer the question and asked callers to request the information by email.

Then, in a true surprise, for the first time, CMS released a statement the following week to clarify the information. On Aug. 20, the statement released read:

“If a hospice has a contract with a DME (that has a Medicare supplier number), the hospice should have a letter in their file from the DME stating the DME has applied and is waiting for accreditation by the 9/09 date.

“If the hospice contracts with a DME that only serves hospice, (therefore no Medicare supplier number), the hospice will need to make sure the same type of letter from the DME is in place in their files. The accrediting bodies are aware that these DME's serving hospice only will be calling for accreditation.

“If the hospice owns its own DME, then no accreditation is needed.”