Going, Going, Not Sold?

Since the passage of the Medicare Modernization Act of 2003, industry experts have been advising DMEPOS providers to become accredited. But with a recent statement by CMS that only 30 percent of providers are accredited, we wonder why people have been waiting.

In 2005 and 2006, providers said they were waiting to find out who the recognized accreditors would be. The accreditors were announced in November of 2006, but still they waited. At that time, many stated the reason for their delay was that they wanted to see where the first 10 MSAs selected for competitive bidding would be. Even though they were announced in April 2007, providers outside of those 10 areas continued to wait.

Their next “postpone-the-process” reason was to see if they were included in the 70 MSAs chosen for round two of bidding. Those cities were announced in December of 2007 along with the “drop-dead” accreditation date for all providers of Sept. 30, 2009.

And now we hear that many of the providers who delayed becoming accredited for any or all of these reasons want to sell their business rather than become accredited. But a surprise announcement from CMS in January of this year has many in this group kicking themselves.

The agency announced that any provider seeking to obtain a new NSC number after March 1, 2008, would have to be accredited first. This applies to the opening of a new business location as well as the purchase of an existing business.

With this ironic twist, these providers are stuck. Without the business being accredited, a buyer (with less than 25 stores) cannot obtain a new NSC number for the purchase of an existing business. How can this be? CMS is looking to curb the activities of fraudulent providers who can close up shop in one location and quickly set up in another before their abuse of the system is discovered.

By requiring that providers be accredited before they can obtain a new NSC number, the expectation is that the bad apples will be rooted out. Yet again, however, this hurts the good guys as well.

Some of CMS' recognized accreditation organizations can award “conditional” or “provisional” accreditation to a new site when they have already accredited the parent location, but this award is subject to the unannounced on-site survey. (Some accreditors don't offer this kind of recognition at all.)