Time's Up!

Unless you've been living under a rock for the past few years, you are no doubt aware that the Medicare Modernization Act of 2003 requires that medical equipment providers who bill Medicare for identified Part B products and supplies will have to become accredited. Accreditation programs for DME have been around for more than a decade, but your company's first attempt at accreditation may prove no small task.

Background

When the industry learned that accreditation would be mandatory, we also learned that accreditation organizations would be the bodies assigned to enforce and manage compliance. CMS is not contracting with state health departments to ensure compliance with this group of standards, as is their practice in home health and hospice.

In September 2005, CMS released 104 pages of draft quality standards with an over-the-top addition of many extreme, and sometimes ridiculous, expectations. It looked as though the contractor CMS used gathered everything every home care provider might be required to do to comply with any regulatory or accreditation requirements, and then turned these tasks into CMS' quality standards. At the time, there was an outcry from the industry, and a sea of comments were submitted.

So in August 2006 — after 5,600 comments had been received on the draft standards — CMS released its final quality standards. These standards, which ended up at only 14 pages, are straightforward and very much reduced from the requirements that had been included in the draft proposal.

Next, all accrediting organizations that wished to be recognized by CMS sent their programs in for review. Some of the programs had existing standards that were more stringent or comprehensive than others. But it subsequently became clear that, ultimately, CMS didn't care what other standards the accreditors required in their programs as long as they had standards that met the government's final quality standards word-for-word.

CMS also required that the accreditors award accreditation to providers who meet the agency's quality standards, regardless of whether or not they pass any additional standards the accreditor may have in place. It will be interesting to see how this is going to work in the upcoming months.

Previously, accreditation for DME has been voluntary, and providers have chosen the accrediting organization they wished to use. Until this year, only some networks and managed care organizations have required accreditation in different areas of the country.