That old song “Will I See You in September” by The Happenings just took on a whole new meaning to members of the DMEPOS industry. It now makes one provider think as they look at another, “Will I see you in September of 2009?”
In a special teleconference on Dec. 19, 2007, CMS identified Sept. 30, 2009, as the date by which all providers billing Medicare for identified Part B products and supplies must be accredited.
Will you be accredited by this date? Will you decide that you will continue to accept Medicare assignment, and the various requirements that participation now requires? Is this the only deadline you need to worry about?
Most accreditors state that it takes from four to six months to complete the accreditation process. Currently, the accreditation deadline for all providers is 21 months away. That might seem like a long time, but in reality, this deadline could be later than others you might be facing.
CMS' approved accreditation organizations have reported that, although they were very busy with accreditation requirements for the first round of competitive bidding, providers were generally not coming forward to apply if they were not facing a deadline of some sort. As an industry, HME's “wait-and-see” culture seems to be alive and well. CMS hopes that announcing its “drop dead” deadline will get providers to move forward and not wait to become accredited.
There were 753 participants who dialed in to the teleconference. During the one-and-a-half-hour call, only about 15 minutes were spent on the deadline announcement. The remainder of the time was spent answering (or not answering) questions posed by callers.
Certainly one of the most alarming aspects resulting from the questions posed was the number of callers who stated that due to the limited amount of products they provide to Medicare beneficiaries, they understood they would be exempt from the accreditation requirement.
This is another one of those “wishful-thinking” statements that providers have gravitated toward for the last three years, even though industry experts and CMS officials alike have been trying to convince them otherwise. CMS' Sandra Bastinelli, who is in charge of the agency's accreditation program, made no bones about it as she stated to these callers over and over: “No one is exempt” and “There are no exceptions.”
What is one of the first lessons we can learn from this? There are still an enormous number of providers who are hoping accreditation will simply go away, that they will be exempt and that they do not have to go through the process. There are still other providers who may say, “I'm not going to take Medicare assignments after the accreditation requirement goes into place.”
All of these folks need to remember another axiom that long-time health care providers will tell you: “As goes Medicare, so does Medicaid and other payers.”
Unless you run a cash-only business, over the next few years you are going to face accreditation requirements from many of the payers you accept, from state Medicaid programs to national and regional third-party payers. Already there are several regional Blue Cross carriers that require their network participants to be accredited, with more to come in 2008.
In July of 2007, the Oklahoma Medical Assistance “Sooner Care” Program sent all network providers a letter informing them they had to be accredited by Dec. 31, 2007. The state has since rescinded this deadline, but has advised providers that the requirement is coming and that a new deadline will be announced.
And, for any providers who want to take part in the next round of competitive bidding, which will add 70 competitive bid areas, there will be a deadline before Sept. 30, 2009, to become accredited in order to submit bids.
So the question remains, “Will I see you in September of 2009?” Or, will you be out of business because you waited too long to become accredited and can no longer expect reimbursement from Medicare as well as most of your other payers? That is the real question raised with this announcement!
may be later than others you could be facing.
Mary Ellen Conway, RN, BSN, is president of Capital Healthcare Group, LLC, Bethesda, Md., which provides health care management expertise in accreditation preparation and survey follow-up, operations assistance, design of quality improvement programs and outcome measures. She can be contacted by phone at 301/896-0193 or through www.capitalhealthcaregroup.com.
