Accreditation confusion: Industry calls foul on VA

YARMOUTH, Maine - Some VA hospitals may be inappropriately restricting competition by stating that they will do business only with JCAHO-accredited HME providers.

“The law is clear: You do not have to be JCAHO accredited,” said Jeff Baird, a healthcare attorney with Brown & Fortunato in Amarillo, Texas. “The VA policy is that you can be accredited by any of the CMS-approved accrediting organizations, as long as they meet the JCAHO standards. It seems that several of the (VA) medical centers have gotten off the reservation.”

This is the second time in the past few years that some VA hospitals have upset providers by attempting to limit contract arrangements with JCAHO-accredited HMEs.

“A lot of people are saying, 'I chose a different accrediting body because they had deemed status with CMS and were equivalent to JCAHO; now I may be locked out of business,'” said Jerry Keiderling, president of The VGM Group's US Rehab.

The industry figured this issue was settled once and for all when JCAHO issued a memo in April 2007 clarifying its position on accreditation. In part, the memo read:

While there is no centrally directed policy that a VA Medical Center deal only with companies that are accredited by JCAHO, VA has a responsibility to ensure contractors who contract to provide medical equipment and home oxygen services meet the standards articulated by the Joint Commission on Accreditation of Healthcare Organizations. Specifically, the contractor can be accredited by any national accrediting body for home care/home oxygen services; however, the standards set by that accrediting body must at least meet JCAHO standards.

In another memo on this issue, the VA wrote:

Some Medical Centers are misinterpreting this policy as requiring accreditation by JCAHO from these contractors. This is a misconception, and may be an inappropriate restriction on competition.

The current VA controversy is most likely a simple misunderstanding, say industry watchers. Since most hospitals are JCAHO accredited, some VA officials probably assume other providers they work with must also be JCAHO accredited, said Sandra Canally, president of the Compliance Team, a CMS-approved accrediting body.

Baird is working with HQAA, another CMS-approved accrediting body, to help clear up the misunderstanding. He expects the VA will reaffirm its position that its medical centers can work with JCAHO-accredited providers or with providers accredited by an equivalent organization.

Until that happens, HME providers who run into this problem with a VA medical center have several options, Baird said. They can show the medical center a copy of the 2007 clarification; they can give the memo to their U.S. representative and have the representative call the medical center; or they can seek legal help.

“I don't anticipate a major problem,” he said.