NSC backs off draconian enforcement

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Monday, May 31, 2004

WASHINGTON, D.C. - Industry complaints that the National Supplier Clearinghouse has adopted a draconian or unreasonable approach to enforcing the 21 supplier standards have not fallen on deaf ears.

“We’ve heard supplier concerns about some of the standards and the site visit process, and we are working to address them without endangering the trust fund by lowering the bar too much,” a CMS source told HME News last month. “I think we have taken some reasonable steps.”

Typically, suppliers that the NSC deems to be non-compliant with one or more of the 21 supplier standards are given 15 days to prove compliance or lose their supplier number. As of April 15, the NSC began notifying suppliers with issues of non-compliance not considered egregious that they have 21 days to prove compliance before the 15-day revocation action begins, said NSC Director Nancy Parker.

That said, it is never acceptable to be out of compliance with any standard at any time, even if easily correctable, Parker added.

“It is important to note that these 21 supplier standards have been in effect since December 2000,” she said. “If a provider is not in compliance with a particular standard, we should not be looking the other way.”

Because all situations are different, Parker declined to say what offenses might qualify as non-egregious.

The NSC also has begun revamping its site-visit questionnaire. When completed, it will rely less on yes and no answers, gathering instead information that provides a more complete picture of a supplier’s business. The result should be a clearer picture of whether or not a provider is in compliance with supplier standards, the CMS source said.

The changes at the NSC should be welcome news to providers and industry watchers. The NSC began its more aggressive enforcement of the supplier standards last fall, following revelation that it granted supplier numbers to crooks who billed Medicare for tens of millions in phony power wheelchair claims.

Providers and industry watchers welcomed the stepped-up effort to weed out fraudulent players. Reports soon began to surface, however, of providers losing supplier numbers for not having their store hours posted, not being listed in the yellow pages and a number of other “picky” infractions that could be easily corrected.

“If you do everything perfect, you are fine,” said healthcare attorney Neil Caesar. “The consequence of imperfection, however, should not be a nightmare.”

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