LAS VEGAS--HME providers and others with ties to home health care gathered at the Las Vegas Convention Center last week to take in educational sessions and peruse new technologies at Medtrade Spring. The trade show took place as the industry prepares for big changes, with competitive bidding and mandatory accreditation for Medicare suppliers on the horizon.

Like many providers, Vince Kasiar, president of Beck's Home Health Care Products, Eldorado, Ill., came to learn about accreditation and, ultimately, sign up to get the process rolling. "We're hoping to finalize the paperwork today," he said.

Kasiar's comment mirrored those of many show-goers who intend to ramp up efforts toward accreditation. Show organizer VNU Expositions offered several sessions on the subject.

Currently, the majority of the nation's HME providers remain unaccredited, according to most estimates. That's a situation some fear could create major challenges for CMS, which is charged with the implementation of DME competitive bidding in 2007; suppliers must meet government quality standards to participate in the bid. And at some point--although the exact date has not been set--all providers must be accredited to participate in the Medicare program as mandated by the Medicare Modernization Act.

But time, observers say, is running out. John Gallagher, vice president of government relations for Waterloo, Iowa-based VGM, said that only 40 percent of the buying group's members are currently accredited. "The concern now," Gallagher commented during a Tuesday-afternoon session, "is [whether] the accrediting bodies can take care of the remaining 60 percent."

While its contractor, North Carolina-based Research Triangle Institute, has unveiled a preliminary draft that sets out eight "quality standards domains" for suppliers, CMS is not expected to finalize the standards until this summer--nor has the agency designated any accrediting body to enforce them. Lacking that information, some show attendees expressed concern on how to move forward. "I don't understand how I'm supposed to be accredited when CMS hasn't told me who can accredit me and what the standards are," said Jerry Jeanes, owner of Denton, Texas-based Choice Medical Equipment.

Jeanes made the comment at a session called "Dueling Accreditation Services," which included representatives from ACHC (Accreditation Commission for Health Care), CHAP (Community Health Accreditation Program) and JCAHO (Joint Commission on Accreditation of Healthcare Organizations). Of the 200-plus providers who packed the room, only about 10 percent raised their hands when asked if they were accredited.

As of March 1, the count from the National Supplier Clearinghouse puts active DMEPOS supplier numbers at 113,801. According to consultant Bob Weir of Weir & Associates, Warner Springs, Calif., ACHC, CHAP and JACHO estimate that together, the organizations have accredited 6,000 Part B suppliers. Those organizations have approximately 200 surveyors among them, Weir said, and each performs an average of two projects each month. "Do the math," Weir said. "To get the remaining suppliers accredited, it would take [more than 20 years]."

During the show, CMS contractor RTI, which is advising the agency on implementation of the bidding program, held a series of small provider focus groups to hear their concerns about quality standards, accreditation and the competitive bidding and selection process. The research firm is planning similar focus groups in Chicago and Dallas, although dates have not been announced.

To view the latest on competitive bidding, including RTI's presentations on quality standards and bidding process options, visit CMS' competitive acquisition Web site, available by clicking here.