Home Health & Hospice Week

Don't delay in seeking accreditation.

Durable medical equipment suppliers won't have to wait much longer to get a glimpse of the quality standards they'll be held to under competitive bidding.

At the Program Advisory and Oversight Committee meeting held Feb. 28 through March 2, the Centers for Medicare & Medicaid Services announced its plans to issue draft standards this summer.

CMS will base the standards on the requirements of organizations that currently accredit DME companies - things such as compliance with all applicable laws, meeting state DME licensure rules, ownership disclosure, safety management, etc.

CMS plans to release the standards in the form of a program memorandum rather than publishing them in the Federal Register in hopes of speeding up the process. The agency needs to issue the standards as soon as possible so suppliers can begin complying with them in advance of the first stage of competitive bidding, which is set to begin in 2007.

Cause for concern: The announcement sparked worries among some committee members, who noted that program memos typically do not involve an official comment period. But the agency assured the PAOC that it would seek public input.

"CMS indicated very clearly that they want the industry to have adequate time to provide comments on these quality standards," PAOC member Seth Johnson of Pride Mobility Products Corp. of Exeter, PA tells Eli.

Now's the Time to Get Accredited

The second day of the meeting was devoted to a discussion of supplier standards and accreditation.

"There was a strong consensus from the PAOC that the quality standards and accreditation bodies need to be in place and providers need to be accredited or well on their way to being accredited before they can bid," reports PAOC member Don Vliegenthart, medical director for Hoveround Corp. in Sarasota, FL.

Most PAOC members believe it would be unfair to allow unaccredited suppliers to bid against their accredited counterparts, as unaccredited suppliers couldn't know what their actual costs would be before going through the process, explains Vliegenthart.

CMS had not yet sent out the paperwork that accrediting bodies must complete to be considered an approved accrediting entity for Medicare purposes, participants also noted.

That worries Johnson, who says he regularly gets calls from suppliers asking what they should do to prepare for competitive bidding. When he tells them to consider getting accredited, they point out that they don't yet know who the approved accrediting entities are going to be. "How can you really begin preparing when you're not even sure who is going to be approved?" Johnson asks.

He suggested at the meeting that CMS consider a grandfather clause covering suppliers who get accredited before the official accrediting organizations are selected.

Get moving: Vliegenthart expects CMS to heed that suggestion, so there's no reason to delay in pursuing accreditation, in his opinion. "I can't see why anybody who wants to continue to participate in DME competitive bidding would wait to get accredited," he maintains.

Small Suppliers Get a Shot

Ensuring small suppliers' ability to participate in the competitive bidding process was a theme that ran throughout the meeting.

During the opening day's discussion on capacity and demand issues, for example, the committee considered whether suppliers would have to cover the entire metropolitan statistical area included in the bid. Members discussed including small suppliers who currently work in a particular MSA but do not cover the entire MSA.

'Rural' defined: The presentation on rural and low population density exemption authority by the Health & Human Services secretary offered a helpful clarification on what constitutes a "rural" area, PAOC members report: CMS indicated that it considers any area not in an MSA to be rural.

Competitive Bid Rule Coming Soon

Heads up: CMS plans to publish the proposed rule to implement competitive bidding in the Federal Register in late spring or early summer and will accept comments on it through the fall.

That rule will include criteria for selection of the 10 MSAs where competitive bidding will begin in 2007 and the 80 MSAs where it will begin by 2009, the DMEPOS items that will be included and the bid evaluation process. The proposed rule also will include details on the structure of implementation.

No date has been set yet for the next PAOC meeting, but it is expected to take place in summer or early fall after the draft quality standards are released. 

Editor's Note: Competitive bidding information is at www.cms.hhs.gov/suppliers/dmepos/compbid.