Tuesday, November 30, 2004

Beat the fly-by- nighters
with Asela Cuervo

Q. Will accreditation stop fraud and abuse?

A. Many HME providers support mandatory compliance with quality standards and accreditation, yet there are others for whom these MMA provisions continue to be controversial, largely for reasons having to do with additional costs and administrative burdens. As well, many providers don’t believe it will stop all fraud and abuse. While there is a grain of truth to this argument, putting an end to fraud and abuse is not the only reason to favor accreditation and quality standards.

Accreditation and quality standards are likely to be most effective against the blatant, fly-by-night operations that were the focus of “Wheeler Dealer.” This is true because it will take an HME provider time and financial commitments to become accredited. Compliance with third party standards is an ongoing commitment. This will be too much effort for the fly-by-nights. But accreditation and quality standards will also benefit providers beyond putting an end to sensational headlines.

HME providers are part of the “continuum of care,” but, unlike other providers in the continuum, they do not have to meet Medicare conditions of participation or be accredited to serve Medicare.The public tends to view them mostly as vendors who deliver equipment and provide little professional service. Accreditation and quality standards can enhance the public image of the HME community. Accreditation will serve as a public benchmark of an objectively verifiable level of quality. As this becomes the norm, the public will begin to view the HME community as “providers” who are truly part of the continuum of care rather than merely “dealers” or vendors who are only an adjunct to it.

Asela Cuervo is the principal in the Law Office of Asela M. Cuervo in Washington, DC. 202 496-1281.