ATLANTA--Although the first round of competitive bidding is set to begin later this month, several DMEPOS accreditors said they are seeing fewer applications than anticipated from providers in the 10 MSAs where the program will roll out.

Mary Nicholas, executive director of the Healthcare Quality Association on Accreditation said that while the organization was fielding calls from providers in the designated competitive bidding areas--mostly from the Dallas-Fort Worth-Arlington CBA--there had not been as many as she had expected.

"When I saw Texas was really checking in, I said, 'OK, we're going to see some of the other MSAs doing the same," Nicholas said. "But I haven't."

Although providers are asking more detailed questions, she said, she didn't "sense any urgency yet."

Sandra Canally, president and founder of The Compliance Team, said she is puzzled by the situation. "It's just mind-boggling," she said. "We've got the MSAs, we've got the products, we've certainly got an aggressive timeline as it relates to the bidding ... What are these people doing?"

Complicating the issue is the fact that CMS has not set a definite deadline by which providers must be accredited. Canally said CMS was supposed to be giving the accreditors a final date, but hadn't yet.

"I assume in the next week or so we should know a specific date," she said.

When CMS opened bidding registration last Monday, with a 60-day bid window to open late this month, the agency stipulated that suppliers must be accredited or be pending accreditation before submitting a bid. CMS has also said bid contract winners must be accredited, and that winners would be announced no later than December.

But without a concrete deadline, accreditors said they don't know if that means providers have until winners are announced (which some suspect could be even earlier than December), or until April 2008, when the bidding program is scheduled to be implemented. Regardless, they emphasized, unaccredited providers who want to bid must submit applications as soon as possible.

If CMS does require that providers be accredited by December, do they still have time to complete the process?

The answer is yes, according to Canally, who said her organization has created an accelerated two-month program for providers in the initial MSAs. Nicholas also said providers who are focused on completing the process can get through it in time. And Tim Safley, HME clinical advisor for the Accreditation Commission for Health Care, said that, as of Friday, accreditation could be completed within three to four months.

"Right now, we're ok," he said. But he added that inquiries are "way up," and if applications suddenly come flooding in, "that could change."

Nicholas also pointed out that providers waiting until the last minute could find themselves even more pressed for time. For example, a provider that fails an accreditation survey would have to resubmit for review. At HQAA, she noted, the board of directors, which meets quarterly, must approve such resubmissions, so a company that didn't pass a survey near the end of 2007 would have to wait for the board's January meeting.

The bottom line, said Canally, is that providers in the first 10 MSAs "all have to take action, and they all have to take action now, or they're going to be left behind."

For a list of CMS' 10 approved accreditation organizations, click here.