Accreditors submit their applications, await word

WASHINGTON - As part of an application process that ended Oct. 2, organizations that want to accredit providers on CMS's behalf had to mesh their programs with the agency's final quality standards. Some were surprised to find out how easy it was. When CMS released its final standards in August, the organizations were shocked to see the agency had downsized its standards from 104 to 14 pages. By tweaking their programs, some organizations feared they would devalue accreditation. "We did make some modifications--we combined some things, we dropped other things," said Tom Cesar, president of ACHC. "But when you look at CMS's 14 pages, most of the standards are general. When we outlined our general standards, they were only 19 pages. It's the explanations that you add in that make it longer." CMS has asked all providers who want to participate in national competitive bidding, which kicks off next year, to seek accreditation. Eventually, it plans to require accreditation of all providers. CMS has indicated that it will select more than one "deeming authority" to accredit providers on its behalf. The accrediting organizations expect to find out who has "deeming authority" this month. They also expect to find out whether CMS believes their programs adequately reflect its final standards. "They could come back to us and say, 'This is fine,' or, 'This is still too much,'" Cesar said. When ACHC applied to become a "deeming authority" for home health agencies, it wasn't approved the first time around, Cesar pointed out. CMS gave ACHC 30 days to make changes, and it approved the organization the second time around. Mary Nicholas, executive director of HQAA, said she's confident her program "fits nicely" with CMS's final standards. Sandra Canally, president of The Compliance Team, feels the same way about her program. "We didn't have to do much revamping--we're already as close as anyone can get," Canally said. "We already have streamlined standards. We already have product-specific standards. It's just the extraneous details." While much of the application process involved giving CMS what it was looking for, ACHC wouldn't "compromise" on some things, Cesar said. "(CMS's standards) aren't clear on safety and infection control--that's one thing we felt we couldn't drop," he said. Knowing that they would have to tweak their programs, providers have been asking accrediting organizations whether they'll now have two programs--an existing program and a CMS program. ACHC won't, Cesar said. "We decided, frankly, that if this is what CMS is requiring, we'll go with it," he said. "But we'll include a comment in our manuals that says, 'This is not based on our traditional program.'"