Stricter AO oversight could increase cost, compliance burden on providers 

YARMOUTH, Maine – CMS is proposing stricter requirements for accrediting organizations (AOs), including increasing the amount, specificity and frequency of data they must submit to the agency. But the majority of respondents to a recent HME Newspoll say that’s unnecessary.  

Seventy-three percent of respondents say the accreditation program does not need to be updated or enhanced. 

“AOs already complete plenty of surveys and info,” wrote one respondent. “Combined with state inspections and Medicare inspections, along with billing history and practices, CMS has everything they need to combat fraud.” 

In its proposed rule, however, CMS said the accreditation program hasn’t been updated since 2006, and it worries that AOs are accrediting providers that don’t meet the quality standards. 

Numerous respondents said they worry the additional requirements for AOs, like the one-year re-accreditation requirement, will mean increased costs and administrative burdens for providers. 

“Stricter requirements for AOs will undoubtedly result in an increase in accreditation fees, as the AOs will have to pass on their added expenses,” wrote Erin Dolan of Med-Essentials in New Hartford, Conn. “This would be another blow to small DME companies, making it that much more difficult to survive in the landscape of unsustainable reimbursement.” 

Another respondent didn't disagree that CMS needs to better monitor AOs, but they said the agency needs to find a way to do it without increasing the burden on providers. 

“AOs should maintain full transparency with CMS to ensure accountability and uphold public trust,” wrote one respondent. “However, this transparency must not come at the cost of increased administrative burdens on suppliers, which can drive up operational costs and hinder access to care. Instead, CMS should take a more active role in publicly detailing its own efforts to monitor and evaluate AOs, demonstrating a balanced and collaborative oversight approach that supports both quality assurance and supplier sustainability.” 

In addition to increasing their data reporting, CMS proposes to: 

• Expand its ability to closely monitor and review the operations of AOs; and 
• Strengthen its ability to act against poorly performing AOs. 

“I definitely think that AOs need to be refreshed,” wrote one respondent. “There are still a lot of antiquated methods and measures that they look to enforce. Some of the requirements that AOs are trying to enforce are suited to 20-30 years ago when reimbursement was much higher and DMEs could afford to hire staff.” 

“I definitely think accreditation standards need to be updated,” agreed another respondent.