Quality Standards

One of the biggest issues connected with CMS' implementation of competitive bidding is development of quality standards. At a meeting last month of the Program Advisory and Oversight Committee (PAOC), which is advising CMS on the program, CMS and its contractor, Research Triangle Institute (RTI), unveiled a preliminary draft outline of quality standards for DMEPOS suppliers. The draft provides an overview of the approach CMS plans to take in establishing eight “quality standards domains,” with a series of requirements in each of those domains as follows.

Organizational Structure — Compliance with federal, state and local laws; disclosure of ownership and financial interest; status and location of business/access to care and services; contracts/agreements; policies/procedures on scope and provision of services, coordination of care, disaster plan, replacement and rental of equipment; Medicare supplier enrollment process; normal and emergency operating business hours and services provided.

Financial Management — Financial management plan that includes an annual operating budget and capital expenditure plan prepared according to generally accepted accounting principles; projected and actual income, expenses and balances; acquisition and improvement of land, buildings and equipment; expansion of buildings and equipment; and invoices and receipts of each beneficiary's equipment and supplies.

Human Resources — Licensure, registration, certification, qualifications of staff; competency of staff; criminal background checks.

Patient/Client Management — Physician orders, CMN, assessment; equipment/supplies delivery, set-up, safety, monitoring replacement, pick-up; beneficiary education, training, monitoring, follow-up, emergency response, participation in plan of care; self-administration, beneficiary requires assistance; coordination of care with physician and other providers; infection control practices; product-specific requirements (e.g., oxygen, hospital beds, orthotics, wheelchairs, pressure reduction devices, adaptive equipment); provision of care and services with respect and maintenance of beneficiary's dignity; confidentiality; discharge form services.