Accreditation anxiety: Industry encourages CMS to set drop-dead deadline

Sunday, October 28, 2007

WASHINGTON - By taking its time to set a final deadline for mandatory accreditation, CMS, which has had nearly four years to do so, is making it easier for crooks to pose as DME providers and defraud Medicare, say industry watchers.

"If CMS is trying to crackdown on fly-by-night operators, having an independent entity double check what the National Supplier Clearinghouse is doing would clearly be a positive step," said Walk Gorski, AAHomecare's vice president of government affairs. "Accreditors have a vested interest in visiting any provider they accredit; otherwise, they will be blamed for letting in bad actors."

All providers who plan to participate in the first round of national competitive bidding must be accredited by Oct. 31. Industry officials now want CMS to set a final deadline for mandatory accreditation--the date that all providers who want to bill Medicare must meet. Until CMS does that, many providers will most likely continue to delay becoming accredited, say industry watchers.

"CMS has to create a sense of urgency, accreditors can't," said Sandra Canally, president of The Compliance Team.

"There is a lull (in accreditation)," said Mary Nicholas, executive director of Healthcare Quality Association on Accreditation (HQAA). "It's almost scary quiet."

The Medicare Modernization Act, which required, among other things, mandatory accreditation for all DME providers, was signed into law by President Bush in December 2003. When compared to competitive bidding, setting a date for mandatory accreditation appears fairly simple, but it's apparently easier said than done, and requires jumping through a number of hoops. CMS has also had some senior management changes since the MMA passed and that may have delayed the agency setting a final deadline, Canally said.

Industry watchers fear that as long as CMS delays setting a final deadline for accreditation, both nationally and for next year's second round of competitive bidding, providers will continue to procrastinate starting the process. That's not good, they say.

"The longer CMS puts it off, the less time providers have to react," Gorski said. "We'll get into a situation where the accreditors are overwhelmed and the suppliers don't have enough time. Our message to CMS has been to cut through the red tape and do what is necessary to announce an accreditation date."