Tallahassee, Fla.
A Florida state house bill was introduced last month that would require the state's HME providers to become accredited in order to obtain and maintain their state licenses.
According to some observers, this is welcome news in an area of the country that has seen its share of Medicare fraud. “It increases standards for providers throughout the state,” said Javier Talamo of Kravitz & Talamo, Hialeah, Fla., and vice president of the Florida Association of Medical Equipment Services (FAMES).
House Bill 179 proposes mandatory accreditation for all Florida DME suppliers, obtained from one of the industry's accrediting bodies, including JCAHO (Joint Commission on the Accreditation of Healthcare Organizations), CHAP (Community Health Accreditation Program) and ACHC (Accreditation Commission for Health Care). FAMES is hoping a similar bill will be introduced soon in the state senate. The entire legislature returns to the state capitol in March.
The idea for such a bill came from continual negotiations between HME providers and state officials over proviso language in the state budget passed last year. The language requires Medicaid payments on most DME to be no more than 80 percent of current rates. It also states that a “qualified vendor must be nationally accredited and in good standing with the agency and [CMS].” Although last year the language was interpreted to mean “competitive bidding,” those words do not appear in the proviso language.
The state's intent, Talamo said, is to shave 20 percent off of what it pays for Medicaid DME claims. Through talks with state officials, FAMES is hoping to produce those savings through two proposals.
The first is the mandatory accreditation bill, which Talamo said will reduce fraud and, ultimately, save the state about 10 percent. The rest of the savings would come from across-the-board reductions of DME Medicaid reimbursement to occur incrementally over several years.
