BALTIMORE--CMS will meet today with its newly approved DMEPOS accreditors to relay additional information about what the agency expects from those organizations--and Medicare Part B suppliers.

Shortly before Thanksgiving, CMS announced that 11 accrediting bodies had been granted "deeming authority" to apply its new quality standards, mandated by the Medicare Modernization Act for providers who will participate in competitive bidding next year. (See HomeCare Monday, Dec. 4.) However, no further information about what the agency expects as far as deadlines for accreditation, or about what the new standards mean for providers that are already accredited, has been released.

The "biggest" questions he would like answers to, according to Tom Cesar, president of the Accreditation Commission for Health Care, are:

--When are the metropolitan statistical areas where bidding will begin going to be announced?
--What about grandfathering? What are the rules for DME companies that are already accredited?
--When will the new standards actually be applicable to providers? What date?
--Is there a particular structure for provider networks with guidelines or rules for accreditation and competitive bidding?

About these questions and others, said Cesar, "We have concerned customers."

Added Sandra Canally, president of The Compliance Team, "CMS needs to communicate the identity of the first 10 MSAs to both the accrediting bodies as well as the rest of the industry ASAP so that we can all move forward with our individual contingency plans. Without that information," she continued, "it makes no sense for us to ramp up our operations in areas that will not be affected by the initial roll-out of the MMA competitive bidding process."

In a CMS Open Door Forum last month, a CMS official said the names of the 10 cities where bidding will begin won't be released until the final rule on competitive bidding is issued. While insiders believe the rule could come down before Christmas, the bidding locations are expected to follow at a later date.

But also at the Open Door session, the agency official noted that providers who want to participate in the 2007 bid should be accredited by early in the year. That's troubling to accreditors, who said they are hoping to get clarification today on when the actual accreditation deadlines will be.

The previous rule of thumb for completing the accreditation process through the industry's established accreditors was estimated at a year or more. However, both ACHC's Cesar and Mary Nicholas, executive director of Healthcare Quality Association on Accreditation, said their new CMS-based programs would take approximately six months to complete. Canally said providers may be able to complete The Compliance Team's program in four months.

That could still leave some providers in a jam with estimates of thousands of HME companies/locations currently unaccredited. According to HomeCare magazine, the percentage of providers accredited in 2005 has jumped substantially, from 43 percent to 52 percent in 2006. But experts say the capacity may not exist to get the remaining affected providers through the process in time.

The advice to unaccredited providers from industry consultant Mary Ellen Conway, president of Capital Healthcare Group, Bethesda, Md.: "Just don't wait." Although CMS is behind in its timeline for the competitive bidding ramp up, Conway said, some companies could be left at the gate unless CMS grants a grace period for those who are only part-way along in the process.

CMS has asked accreditors to give preference to providers in the bidding areas that are chosen, and the agency also said it will allow accreditors to consider previous accreditation, Medicare certification and licensure that would indicate its quality standards are being met.

But specifics about exactly how this will work are lacking, Conway said. "What is CMS going to require to ensure that companies who have previously gone through the process meet the new standards?" she questioned. "Do they just want a questionnaire from the individual provider or will it be something more formal? The accreditors need to understand what this means on their end."

And there are numerous additional details that must be ascertained about the quality standards themselves.

Nicholas, for example, said she is looking for more information on the Appendix B rehab standards. "One of the most frequently asked questions we've received from providers is if their manual wheelchair business falls under the section requiring the technically trained staff. I would like to gain further clarification on that issue."

Plus, she continued, "HQAA needs to hear the expectations for the numerous reporting processes that CMS requires. When do they want reports of the accredited providers? Will it only matter when the MSAs are identified, or can Medicare provider numbers/NPI numbers be sent now?"

Nicholas said she is hoping today's meeting will address her questions and those of other accreditors. "Providers want to know if they are going to receive reimbursement--that is really the bottom line," she said.

To view CMS' supplier quality standards, visit www.cms.hhs.gov/CompetitiveAcqforDMEPOS/04_New_Quality_Standards.asp.

For a list of the 11 approved DMEPOS accrediting organizations, visit www.cms.hhs.gov/CompetitiveAcqforDMEPOS.