Providers scramble to craft bids, get accredited

Sunday, June 24, 2007

WASHINGTON - It's getting hairy out there for providers who plan to participate in the first round of competitive bidding but who aren't yet accredited.

"For many, the burden of going through accreditation and the bid process is just about too much," said Mary Nicholas, executive director of HQAA. "We can hear the stress; sometimes we can see the stress."

Providers in the first 10 competitive bidding areas (CBAs) learned this spring that they have until July 13 to submit bids and until Aug. 31 to become accredited. Providers who aren't accredited can't bid. Additionally, providers who don't submit their paperwork to an accrediting agency by early July will probably miss the Aug. 31 deadline, say accreditation officials.

In 2008, CMS will expand competitive bidding to an additional 70 bidding areas. Providers who suspect they may be in the next round should get accredited ASAP, say accreditation officials.

And for good reason. As HMEs now scramble to get accredited, all kinds of problems have developed. For example, in their mad dash to submit the necessary paperwork, many providers "are not submitting the appropriate information" and cannot be surveyed until they do, said Rob Summitt, a surveyor for ACHC.

Additionally, ACHC has seen an increase in the number of providers who submit the appropriate paperwork but then fail their surveys, said Sherry Hedrick, director of clinical compliance for the accrediting agency.

"I think it is because people waited until the last minute and didn't put the effort into it or didn't realize the effort it was going to require," she said.

Industry consultant Mary Ellen Conway said she's "amazed" at the number of pharmacies that planned to bid a few months ago but now say they won't--either because they expect reimbursement to be too low, they don't do enough DME business to justify the effort or they can't provide sufficient geographic coverage.

Some HMEs have also decided to opt out.

"They have looked at everything they have to do right now and said, 'We can't do it,'" Nicholas said.

As expected, accreditation officials report increased business in all 10 CBAs. While many providers procrastinated, many others have done the work necessary to become accredited.

"I give a compliment to the people out there who didn't want to wait until the last minute," Hedrick said. "That shows how smart they are."

Providers who expect CMS will extend the Aug. 31 deadline should think again, say accreditation officials.

"It's a freight train that has left the station, and it's not stopping," said Sandra Canally, president of The Compliance Team. "That is how we are looking at it."