Confusion reigns at Open Door Forum

Sunday, February 4, 2007

WASHINGTON - Providers who believe they must become accredited to submit bids in the first round of national competitive bidding left last week's Open Door Forum flabbergasted.

CMS's goal is to have all of its Medicare Part B providers accredited--especially those in the top 20 MSAs--as soon as possible. At the forum, however, it became clear that there's no deadline on the books for becoming accredited.

Furthermore, "there is a provision in the statute that does say the quality standards should not delay the start of NCB," stated a CMS official.

"We're hoping, at some point in time, that before we enter into the contracts, we will have the suppliers accredited," stated a CMS official. "That is our goal."

Part of Tuesday's confusion stemmed from a CMS transmittal dated Jan. 26 that stated as of April 1, all DMEs must be accredited in order to get a supplier number and bill Part B. The transmittal was sent in error, say officials, and was rescinded Jan. 29.

But officials stressed continually that providers in the first 20 proposed MSAs should get accredited as soon as possible.

"If you are waiting for the final rule, it's probably not a good idea," said a CMS official.

For providers reluctant to make decisions until the final rule is released, the need to spend time and money on accreditation has been a tough sell. And while callers had questions on a number of topics, it was clear the biggest concern was the accreditation deadline. At times, it was hard to tell who was more confused--CMS or providers:

Caller: Did I hear correctly that suppliers do not have to be accredited before they submit bids, at least for this first round?

CMS: Yes.

Caller: So suppliers do NOT have to be accredited. Do they have to prove they are in the accreditation process?

CMS: Well...we really can't give full details on what's going to be required in terms of who is eligible for entering into a contract for competitive bidding. There are certain parts of the statute that allow us to start the bidding and proceed with the program. We definitely want our contract suppliers to be accredited and be meeting the quality standards. But whether or not you need to be accredited prior to starting the bidding process, umm, it's not as important.

Caller: Let me make sure I understand this. You just said in order to bid, you don't necessarily have to be accredited.

CMS: That's correct

Caller: OK. Let me just comment. I think it's a surprise that you're surprised that more people are not accredited because the level of specificity about this program has been such that it's very difficult to recommend to anyone that they go ahead and get accredited when they don't know the final rules of the game.

One industry insider who listened in on the call spoke to HME News afterward.

"I think the message has to continue to be, you will have to be accredited to bill the Medicare program for DMEPOS items eventually," said the insider. "You might as well get started on that because it's going to take several months to go through the process."