CMS releases proposed quality standards for HME

Sunday, September 25, 2005

WASHINGTON - CMS offered a sneak peak of what will be required of national competitive bidding participants, when it released its much-anticipated proposed quality standards on Friday.

The 104-page draft outlines the standards that providers might have to meet to compete for Medicare business under NCB. CMS and its contractor, Abt Associates, grouped the standards into two categories: business quality standards and product-specific service requirements.

"Because suppliers specialize in DMEPOS products and services, and because of the complexity of the clinical monitoring required for some areas of DMEPOS...the supplier will be accredited only when they meet business quality standards as well as those quality standards that apply to the specific products for which the supplier has applied through Medicare to market and distribute," the draft states.

The standards were released one business day before the Program Advisory and Oversight Committee's meeting with CMS today and tomorrow in Baltimore. CMS and Abt will also conduct a special open door forum on Monday from 4 p.m. to 5:30 p.m. to provide an overview of the proposed quality standards.

To participate in the special open door forum by phone, call (800) 837-1935 and use this conference ID number: 8914408.

The HME industry was still digesting the proposed recommendations on Friday afternoon, but Sandra Canally called CMS's decision to address general and product-specific standards "refreshing."

"That's the approach that's most connected to patients' needs and meeting those needs" said Cannally, president of the Compliance Team.

While the draft doesn't say who will accredit providers, the word on the street is that CMS will follow-up this release with criteria for companies that want to become CMS-approved accreditation organizations.

Business quality standards outlined in the draft address:
- Administration
- Financial management
- Human resource management
- Beneficiary services
- Performance management
- Equipment and safety
- Beneficiary rights and ethics
- And information management

CMS created product- and service-specific standards for:
- Oxygen and oxygen equipment
- Home invasive mechanical ventilation therapy
- CPAP and BiPAP
- Intermittent positive pressure breathing
- Power wheelchairs
- Manual wheelchairs
- Diabetic equipment and supplies
- Customized orthotics and prosthetics
- Enteral nutrition
- Electric and manual hospital beds
- Support surfaces
- Walkers, canes and crutches
- Commodes
- And bedpans and urinals

National competitive bidding is expected to kick off in 10 metropolitan areas in 2007.