Sunday, August 31, 2003

Editor, HME News

As unpopular as the prospect of mandatory accreditation is for a significant portion of HME providers - nearly half of the respondents to a recent HME NewsPoll opposed the measure - it makes sense for AAHomecare to get behind the initiative.

The association was slow to embrace the measure, given the considerable opposition, but has now coupled its car to an engine that’s likely to chug whether we like it or not.

“For us to be on the same plane as some of the other professions out there, we have to have a professional level of standardization,” said Tim Pontius, vice chair at AAHomecare and president of Young Medical Equipment in Toledo, Ohio.

Supporting accreditation isn’t the same thing as supporting the need for every HME business to be JCAHO accredited. There are at least two other reputable organizations - ACHC and CHAP - that offer accreditation, and are likely to be among those designated by Congress if this measure passes.

AAHomecare is supporting flexibility in accreditation so that specialty and rehab providers can turn to other organizations that tailor accreditation programs just for them.

To oppose this measure, or to remain neutral in deference to the industry’s difference of opinion, would be a mistake. If the conferees do support this measure, and the president does sign mandatory accreditation into law, a trade group that opposes it would not likely get a seat at the table of those policymakers charged with the development of a new standards initiative.

Furthermore, what’s to be gained by opposition? It’s not likely that some very determined members of Congress are likely to both cede competitive bidding to the industry’s argument and sanction business as usual vis a vis accreditation, no accreditation as it were.

Let’s face it. This industry has been inordinately tainted by a smidgen of its participants. The largest undercover healthcare fraud investigation in the FBI’s history - Durascam - involved the set-up of a phony HME company. That’s not incidental or coincidental or singular. A DME company was at the center of another undercover healthcare fraud investigation that just resulted in one of the largest, perhaps second largest, healthcare fraud settlement in U.S. history. (See “‘Free’ enteral pumps cost Abbott $600M”)

The industry can run from competitive bidding. It’s been running from it for years, and even if the industry skirts the long-standing desire to bring market forces to the provision of medical equipment and services in the home, that Congressional desire will likely get a bearing on this industry again. Unless…

Unless HMEs can point at some calligraphy on the wall of their location, as doctors and nurses can do, and point toward a certificate of accreditation that really means something. It’s no guarantee, but competitive bidding, historically, has been a means of fighting fraud and abuse and waste in Medicare. If accreditation can have an impact on fraud and abuse, maybe it will have an impact on waste as well, and at long last there’ll be an end to the uncertainty associated with reimbursement. HME