ATLANTA--Despite CMS' extension of the accreditation deadline for HME providers wishing to participate in competitive bidding, accreditation organizations still are not seeing a surge of applicants, they told HomeCare last week.

On July 27, the previous deadline, CMS extended its bid window to Sept. 25. It also extended the accreditation deadline from Aug. 31 to Oct. 31. Providers must be accredited to be awarded a contract in the initial round of the bidding project.

"We're not seeing a flurry of activity right now. I think that individuals that [plan to bid] have already applied," said Robert Floro, R.R.T., newly promoted director of the home care accreditation program for The Joint Commission.

Terry Duncombe, president and CEO of the Community Health Accreditation Program, said phone calls regarding accreditation escalated after the announcement of the deadline extension. But overall, she said, "it hasn't been the numbers that anyone thought. We've had a fair amount of agencies already accredited. From January 2007, we've had 80 organizations that have started the process with us, probably 40 of them since April."

Like other accreditors, however, CHAP was prepared to serve many more applicants. "We're poised to take on quite a bit more," Duncombe said. "We could without a doubt handle another 65 to 75 agencies."

In announcing the bid program during an early April press briefing, then-acting CMS Administrator Leslie Norwalk said the agency had estimated "generally that we'll have maybe 20,000 bids, and about half of [those suppliers] would participate in this program." While CMS will not reveal how many bids it has received so far, stakeholders have surmised that the numbers are far below those anticipated.

Floro said he was not surprised that even after the deadline was extended, few new organizations have applied for accreditation. "If they weren't ready a month ago, what makes anyone think that organizations are going to be more ready for accreditation now? They haven't prepared to this point, so extending the deadline [is not going to make much difference]," he said.

Both he and Duncombe said they had contacted previous applicants who either tried to apply too late in the game or did not complete the process before the initial deadline.

"We've already reached out to those we had to turn away," Floro said, adding that initially there was "a significant collection of organizations" that applied for accreditation but did not complete the application process.

While it might not result in significantly greater numbers of applicants, Duncombe said the deadline extension could help cut down on the number of deferrals. "As [providers] try to rush and get ready [for onsite visits], we are seeing an increase in our deferrals because they are not quite ready," she said.

Mary Ellen Conway, president of Capital Healthcare Group, Bethesda, Md., said the biggest help with the accreditation extension "is that everyone who is trying to get a survey now can do a better job on what they are pulling together."

She said the extended deadline would likely eliminate "heavy, expensive follow-up" because providers would have more time to prepare. "It's really intended to give people more time to do a better job at what they are doing," she said.

Conway did call the extension a "huge win" for those companies who got their money back from accrediting organizations because they had applied too late to meet the initial deadline. If they act immediately, they can still be a part of competitive bidding, she said.

Duncombe also cautioned that providers wishing to bid in the first round can't wait. "They need to do it now. If they are not in our pipeline in the next 30 to 45 days, [the extension] is not going to matter," she said.

While accreditors are generally giving priority to providers in the initial 10 CBAs, there is only so much latitude, they said.

"We have 1,500 organizations that need resurveying, as well," pointed out Floro, referring to those providers that are already accredited but must be resurveyed in order to maintain their status.

The accrediting bodies are also mindful that there could be an onslaught of new applications next year. Not only will providers be preparing for the second round of competitive bidding, but CMS is expected to implement a requirement in the near future that all HME providers be accredited.

Tom Derrick, director of public relations, marketing and professional discipline for the American Board for Certification for Orthotics, Prosthetics and Pedorthics, said his agency's applications in 2007 have tripled in number in comparison with previous years. "We expect the pace to pick up even more in 2008," he said.

Floro noted that providers wishing to do business with Medicare soon won't have a choice. "CMS will announce the date shortly when all the [HME providers] will have to be accredited. So it's a matter of do you do it now or do you do it later," he said.