Advanced Search

Home Health & Hospice Week

Accreditation:

Florida Considers Mandatory Accreditation for HME

Published on Mon Jan 17, 2005

Legislation could inspire other states.

Think you needn't bother with accreditation? You might need to think again.

While the federal government is still talking about quality standards for durable medical equipment suppliers, Florida has become the latest state to take matters into its own hands. That could mean big changes for suppliers in the Sunshine State - and in other states that look to Florida as a role model.

State Rep. Julio Robaina last month introduced House Bill 179, which requires home medical equipment suppliers to be accredited to get or renew their state license. The Miami Republican says the fly-by-night operations he saw opening around his city, a notorious hotbed for DME fraud, inspired him to pen the bill.

"Two new ones just popped up recently in the shopping center where one of my offices is located," Robaina says. The schemes are being carried out "almost openly, with no respect for how fraudulent this really is," he charges.

In an effort to shut down shady dealers, Robaina's bill would require HME providers to be credentialed by one of the three major HME accrediting bodies: the Joint Commission on Accreditation of Healthcare Organizations, the Community Health Accreditation Program or the Accreditation Commission for Healthcare.

Robaina's measure also would:
 

  • increase the amount of liability insurance required of HME providers from at least $250,000 per claim to $300,000;
     
  • mandate that high-tech medical equipment providers - HME companies offering ventilator or tracheotomy care, life-sustaining or technologically advanced equipment, or similar services and products to patients under age 21 - have on staff at least one licensed respiratory therapist who is a certified RT, a registered RT or a registered nurse;
     
  • order HME providers to maintain safe premises that are fully accessible to all patients between the hours of 9 a.m. and 5 p.m.;
     
  • require suppliers to offer customers appropriately staffed after-hours emergency services; and
     
  • create a statewide toll-free telephone number for reporting suspected HME fraud and abuse at 800-962-2873.

    Leaders in the state's HME industry say they generally support accreditation requirements. In fact, Javier Talamo - a health care attorney with Kravitz & Talamo in Hialeah, FL and vice president of the Florida Association of Medical Equipment Services - played an important role in shaping Robaina's bill.

    Jumping the Gun on Federal Standards?

    Florida is just the latest state to consider standards for HME. Ohio lawmakers last summer passed a law requiring certain HME providers to be licensed by the Ohio Respiratory Care Board or to be nationally accredited and registered by the Board.

    "We're in the process of writing the rules right now to implement the law," reports Board member Joel Marx, president of Medical Service Companies in Cleveland.

    Ohio's HME law specifically mentions JCAHO as an acceptable accrediting organization, but the Board is considering accreditation from other bodies as well. The final rules are expected to be out in the spring, with a public hearing planned for April.

    To date, at least 17 states other than Ohio and Florida require some form of licensure for certain DME suppliers, according to data provided by Marx. They are Alabama, Arkansas, California, Connecticut, Idaho, Illinois, Maryland, Missouri, Mississippi, North Carolina, Nebraska, Nevada, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. The District of Columbia also has its own DME licensure requirements.

    However, states' efforts to be proactive on DME regulations raise the possibility of disparities between state requirements and pending federal regulations.

    "We have talked about that," Marx reports. "It is our hope that the federal government, when they come out with their rules, would accept state licensure" as satisfying quality requirements.

    Though FAMES generally favors accreditation, President Brian Seeley questions whether it's wise for states to jump the gun on mandatory quality standards. What if new organizations arise to meet the burgeoning demand for HME accreditation - would states go back and revise their laws to recognize them? And what happens if the states and feds end up recognizing different accrediting bodies?

    "Why reinvent the wheel if the feds are already working on it?" he asks.

    When Robaina introduced the bill, Florida's DME providers were already in discussions with state officials over accreditation requirements sneaked into last year's budget. That legislation required Medicaid payment on most DME items to be no more than 80 percent of current rates; it also required DME providers paid by Medicaid to be nationally accredited.

    FAMES objected to those measures - and especially to the backroom methods by which they passed. Seeley praises Robaina's more upfront approach to policy making.

    Watch for: Robaina is now looking for colleagues in the state Senate to sponsor companion legislation; he says a few have already expressed interest. In the meantime, he's optimistic about the bill's chances of becoming law - and for serving as a model elsewhere.

    "If this legislation passes," he says, "it will set a precedent for other states to follow."

    Editor's Note: For tips on gaining accreditation, see next week's Eli's Home Care Week.

    • Other Articles in this issue of

    Home Health & Hospice Week

    View All