BALTIMORE--In what turned out to be only a blip on the accreditation radar, CMS has rescinded a change request that gave an April 2 implementation date for Part B providers to be accredited in order to maintain their supplier numbers and bill Medicare.

Issued on Friday, Jan. 26, then withdrawn on Monday, Jan. 29, the transmittal was sent in error, the agency said. In a note to contractors, CMS said, "Transmittal 188 is rescinded and will not be replaced at this time ... We apologize for any inconvenience this may have caused."

But Tuesday afternoon at an Open Door Forum, agency officials once again urged DMEPOS providers to get accredited, and said they were alarmed by the small number of providers they believe have begun the process.

CMS' Joel Kaiser said the agency had expected "a flow of suppliers to get their accreditation" after approved accrediting organizations were named in November, but instead had seen only "a trickle." Kaiser, deputy director of DMEPOS policy in CMS' Center for Medicare Management, said the agency's goal is to have suppliers accredited for the first round of competitive bidding, slated for 10 yet-to-be-named metro areas this year.

At the forum, officials repeated that no specific accreditation deadlines have been set. At a meeting in mid-December, however, CMS told accrediting organizations that suppliers who want to bid in 2007 should be accredited by spring, and that those who want to bid in 2009--when the program expands to 80 cities--should be accredited by spring 2008. After that, Kaiser said at the Open Door, additional bidding areas will be chosen "at the administration's discretion" and, at some point, all Part B providers will have to be accredited in order to do business with Medicare.

"My recommendation is that everyone should get accredited no matter what size area they are in, and they should start the process now," Kaiser said, noting that even the second round of bidding is "just around the corner."

Because CMS has not published its final rule on competitive bidding, required under the Medicare Modernization Act, providers don't know exactly which 10 cities will be selected as the first bidding locations or which products will be included. But Kaiser said the agency's draft rule, issued last May, explained the methodology it will use to choose those cities.

"We also know the law requires accreditation," Kaiser said. "If you are waiting for the final rule it's probably not that good an idea," he continued. "We recognize there is a cost associated with accreditation, but there is also a business risk associated with not being accredited."

Kaiser said CMS aims to have companies accredited before they enter into a competitive bidding contract, but that providers would not be barred from bidding if they are not yet accredited. He said the MMA said that supplier quality standards--which providers must meet in order to get accredited--should not delay the start of bidding.

The explanation confused some listeners once again.

"Did I hear correctly that suppliers do not have to be accredited before they submit bids, at least for this first round?" questioned one phone caller.

"We can't really give full details on what's going to be required in terms of who is eligible for entering into a contract for competitive bidding," came the response. "There are certain parts of the statute that allow us to start the bidding and proceed with the program. We definitely want our contract suppliers to be accredited and [to meet] the quality standards. But whether or not you need to be accredited prior to starting the bidding is not as important."

According to CMS' Sandra Bastinelli, director of the Division of Medical Review in the Office of Financial Management, the accrediting organizations have "reached out" to providers, particularly those in 2007's possible bidding sites. But she said four of the 10 deemed accrediting bodies reported they had no suppliers accredited or "as little as 30."

"The remark came back from suppliers that 'We're just waiting,'" Bastinelli said. "We're not sure what you're waiting for," she told the Open Door audience. "No matter when that rule comes out you have to be accredited ... We don't know how to make that more clear than we already have."

The caller apparently disagreed: "I think it's a surprise that you're surprised that more people are not accredited because the level of specificity about this program has been such that's it's very difficult to recommend to anyone that they go ahead and get accredited when they don't know the final rules of the game."

To view CMS' proposed rule on competitive bidding click here.

To view the agency's required supplier quality standards, click here.

For a list of CMS' deemed accrediting organizations, click here.