Accreditation proposals packed with potential burdens

WASHINGTON – Accrediting organizations (AOs) say CMS’s proposal to reaccredit DMEPOS providers every year will require them to hire additional surveyors and other staff, likely resulting in increased costs for providers. 

Currently, CMS requires reaccreditation every three years 

“All of the AOs will need surveyors,” said Rhonda Pearce, executive director of HQAA. “We’ll also need more in-office people to manage reports. We’ll all have to up our staffing and it could result in higher costs for providers.” 

Will this be an unsustainable burden? 

Pearce says she worries an annual reaccreditation requirement would disproportionately  impact smaller providers. ACHC shares that worry, noting no other deemed program requires reaccreditation that frequently.  

“We do have a number of concerns related to the CMS proposal for accrediting organizations to provide additional oversight of DMEPOS suppliers,” the organization said in a statement to HME News. “A single example relates to the proposed requirement for more frequent surveys. Thirty-six month intervals is the CMS standard for all deemed programs with the exception of a 24-month cycle for laboratories under CLIA oversight. A change for DME could create unsustainable financial burden for smaller, community-based suppliers.”  

Are providers falling through the cracks? 

CMS said the accreditation program for DMEPOS, implemented in 2006, needs to be updated due to potential integrity vulnerabilities. Those vulnerabilities include providers falling out of compliance with the quality standards after becoming accredited, the agency said. 

AOs say, however, that the work of meeting quality standards is a continual process. CHAP says it has made significant investments in education for providers, so there’s opportunity for “self-surveying and reflection” throughout the accreditation cycle, says Dan McPhilemy, senior vice president of marketing. 

“We want them to be proactive in finding those issues,” he said. “So, we provide them with resources to maintain routine compliance.” 

AOs also noted that when a complaint is received or noncompliance is found, providers must address them through follow-up surveys or acceptable correction plans. 

“Once a correction plan is accepted, there is a monitoring process,” said Shannon Dorsey-Dunlap, one of the directors of accreditation who focuses on DME for CHAP. “The site visits are thorough. The organizations uses that quality/process improvement component to continue to manage the correction plan through that three-year period.” 

Do AOs need to be more closely monitored? 

CMS said vulnerabilities in the current accreditation program also include AOs accrediting providers that do not meet the standards. The agency proposes increasing the amount, specificity and frequency of data that AOs must submit to CMS and expanding its ability to monitor and review their operations. 

AOs already have data that they submit to CMS – like accreditation dates, accreditation statuses, deficiencies and complaint investigation outcomes – usually on a monthly basis. CHAP points to changes, like direct observation visit surveys, that CMS has implemented in other provider service lines that provide insight as to what the agency has in mind. 

“We look at that as a bellwether for what may come,” said Kim Skehan, vice president of accreditation for CHAP. 

What’s the next move? 

AOs plan to submit comments on CMS’s proposals by an Aug. 29 deadline – and they encourage providers to do the same, particularly as it relates to the proposed annual reaccreditation requirement. Dorsey-Dunlap believes the industry can help steer CMS in the right direction as it looks, on a broader scale, to reduce fraud and abuse in the Medicare program. 

“I’ve been part of the DME industry for a very long time,” she said. “This industry is resilient. It’s been through a lot of changes. As a community, in coordination with industry associations and other AOs, we’ll be able to give quality and realistic feedback regarding these proposals.” 

• To submit a comment on CMS’s proposals, go here and follow the instructions under the “Submit a Public Comment” tab.