CMS revises quality standards

Sunday, October 26, 2008

BALTIMORE - After months of wait-and-see, CMS released the revised quality standards for home medical equipment last week to little industry fanfare.

The standards, which contain minimal changes, take effect immediately. That means beginning Oct. 21, providers who submitted applications to become accredited must comply with the standards.

Accreditors will determine when to implement the standards for providers who are already accredited or those who are in the process of becoming accredited. Most accreditors plan to have them implemented by the end of the year.

"We're going to make any necessary revisions and have them enforced in the next month," said Mary Nicholas, executive director of HQAA.

The revised standards contain two small changes that will affect providers of power wheelchairs and diabetic shoes.

Power wheelchairs: On April 1, providers had to begin using ATSs to supply certain complex power wheelchairs, those categorized as Group 2 or above. Under the revised standards, they must be on-staff, not contract, employees.

Diabetic shoes: The revised standards contain more in-depth guidance for providers and pharmacists on proper fittings.

Rehab provider Tim Pederson applauds CMS for better defining the ATS requirement.

"With contracted ATSs, there's a potential conflict of interest," said Pederson, CEO of WestMed Rehab in Rapid City, S.D. "They could be working for different providers and telling patients to go to one provider over another. That's the type of thing our industry needs to get away from. We need to do everything we can to demonstrate that we're in compliance with all regulations."

As for the guidance for diabetic shoes: "I didn't see any wholesale changes," said Stephen O'Hare, president of Pedors Shoes. "More than anything, it gives us a more defining document for the different levels of service (providers and pharmacists can provide). I guess it defines more what Medicare expects from them."

Industry stakeholders expect the real shoe to drop when CMS releases specific guidelines for orthotics and prosthetics, probably not until late next year. They expect the agency to revamp certification requirements for those providing custom devices.

With the release of the revised standards, accreditors reminded providers that CMS recommends they have their applications in by Jan. 31, 2009, to meet the Sept. 30, 2009, accreditation deadline.

"The number of phone calls we've received has increased," said Sandra Canally, president of The Compliance Team. "I'm hoping people are finally starting to pay attention."

To review the revised quality standards, go to: