Accreditation, Bidding Issues Crop Up at Open Door

BALTIMORE — Home medical equipment providers peppered CMS officials with questions about hot button issues regarding accreditation and DMEPOS competitive bidding during an Open Door Forum on Wednesday, but came away with little new  information.

Some 516 listeners were on the line for the teleconference, which also covered hospice and home health agency issues, but the bulk of their questions centered on DME.

A Dallas DME provider said her company has a surety bond but would likely not be accredited by the mandatory Oct. 1 deadline. “Will we have to opt out of Medicare billing, and, if so, for how long?” she asked.

CMS’ Jim Bossenmeyer replied that providers who will not be accredited by Oct. 1 have two options: to terminate voluntarily or withdraw from the Medicare program, or simply to wait until their billing privileges are revoked.

“If your billing privileges are revoked, you would not be able to bill the Medicare program for one year,” he said. If providers withdraw voluntarily, they will not be able to bill Medicare until they have met the program requirements and are re-established with the National Supplier Clearinghouse, though they would not necessarily have to wait out the one-year revocation bar.

“So it would be better if I opt out?” the provider asked.

“I think each business needs to make its own decision given their fact set and when they started the accreditation process,” Bossenmeyer answered.

That exchange led to a question about beneficiary service.

“Let’s say you are not accredited but you have a bed out to a patient that’s been out there for eight months and you know after 13 months it’s patient-owned. What would someone do in that circumstance?” the provider asked. “No other company is going to pick them up at month nine. It’s just not feasible; it won’t even pay for the equipment itself. What is that patient going to do?”

Joel Kaiser, deputy director of DMEPOS policy and a CMS veteran of 21 years, said that historically, CMS has left such issues to providers to work out among themselves.

Added Kaiser, “We’re going to really be very intensely monitoring the situation with this one-time transition where we have the implementation of these new requirements to see if beneficiaries are caught in this situation and having difficulty finding suppliers.”