Monday, June 30, 2003

New Medicare legislation
With John Gallagher

Q. The recent Medicare reform legislation from the U.S. Senate Finance Committee contains more than just a DME CPI freeze. This bill also contains a provision requiring accreditation for HMEs. What exactly is being proposed and why?

A. The Senate version of this year’s Medicare legislation, under section 421 (a) requires that the CMS secretary establish a requirement for accreditation to get and keep a Medicare number. It calls for the establishment of an advisory panel to recommend accreditation organizations to the secretary. It is believed that this provision was put in the legislation by Sen. Trent Lott (R - Miss.) as an answer to perceived fraud and abuse within the industry. Of course, those of us in the business realize that there is almost no connection between lack of accredited status and fraud and abuse (just look at the recent list of the high-profile “abusers” and their level of accreditation). As this article is being written, the Senate legislation looks like it is a run away freight train that is likely to become law. The Democrats do not want to be seen as standing in the way of an Rx drug benefit for seniors. The Republican leadership in both houses of Congress is committed to getting an Rx drug bill on the president’s desk prior to the August recess. If this bill does pass, the key to reducing any negative affect is to keep the accreditation process open (i.e. not just JCAHO), competitive (allowing other lower cost accreditation agencies to join in) and meaningful to the average HME provider and Medicare beneficiaries.

John Gallagher is The VGM Group’s vp of gov’t affairs. Reach him at 319-235-7100.