'I don't know what the hell I am going to do'

Wednesday, September 2, 2009

BISHOP, Calif. - Provider Glenn Steinke is the first to admit he put accreditation on the backburner. Major back surgery slowed him down. Then a flurry of Medicare changes for everything from CPAPs to braces to oxygen kept him scrambling.

Now, Steinke is faced with the prospect of losing his Medicare billing privileges Oct. 1. That's because his accrediting agency can't survey him before November, despite the fact that he submitted his application before Jan. 31, the date CMS said providers needed to submit their applications to ensure they would be accredited in time.

"I did put it off," said Steinke, owner of Airway Medical. "I had more pressing issues that Medicare kept throwing at us. (But) I did as Medicare suggested."

CMS's guideline was a general one and doesn't take into consideration individual provider circumstances, said Mary Nicholas, executive director of HQAA.

"It takes at least six months if they already have put together policies and procedures and are ready for survey," she said. "But follow-up activity (if they are not survey-ready) can put them over the deadline."

Providers like Steinke may get relief from a provision in the House healthcare reform bill. The bill would offer a grace period for providers who submit an accreditation application before Aug. 1. It would deem them as meeting applicable standards until they achieve accreditation.

Whether the bill passes--and when--is anybody's guess.

"The provision will most likely be retroactive, but there is that period of unknown that we understand has people frightened," said Walt Gorski, vice president of government affairs for AAHomecare. "We are sympathetic to the predicament that these suppliers find themselves in."

CMS has recommended that providers who won't meet the deadline voluntarily terminate their supplier numbers, and re-enroll in the program once they have met all requirements.

That's certainly an option, says Steinke, but not a great one. He is the only Medicare provider in a rural area that covers 10,000 square miles.

"If I can't get any money for two months, I am going to be hurting," he said. "And what about all those patients? Does Medicare want to leave them in the hospital? I don't know what the hell I am going to do."