Home Health & Hospice Week

Gathering will test group's muscle.

Heads up, durable medical equipment suppliers: If you bury your head in the sand over competitive bidding, you'll likely be bulldozed.

The Program Advisory and Oversight Committee created by the Centers for Medicare & Medicaid Services to help shape competitive bidding will convene from Feb. 28 through March 2 in Baltimore.

Industry leaders say they expect the meeting will be a watershed event - a gathering that not only will make headway in crafting policies to guide competitive bidding but one that will also determine just how much power the PAOC actually wields.

"This will be a pivotal point for the committee," predicts Wayne Stanfield, executive director of the Home Care Alliance of Virginia. "So far CMS has not been listening to it very well."

Stanfield's concern about the PAOC's clout - or lack thereof - is shared by John Gallagher, vice president of government relations for the VGM Group. Speaking this month to the annual meeting of the North Carolina Association of Medical Equipment Suppliers in Raleigh, Gallagher called the PAOC an "oxymoron," complaining that the group has "no real oversight powers."

Gallagher was also critical of what he sees as CMS' haste to set up the new system. "They're rushing to implement something, and they have no idea what kind of impact it will have on beneficiaries," he said.

The upcoming meeting will be the PAOC's first three-day-long gathering. Previous meetings were one or two days.

PAOC will need all the time it can get, given the ambitious agenda. A list of tentative topics for the meeting ranges from payment issues, to impact on small suppliers, to quality standards for participants. The latter will be a top priority for this meeting, according to PAOC members.

"We are going to discuss the quality standards, and we're going to discuss the criteria for the national accrediting bodies," PAOC member Maryanne Popovich of the Joint Commission on Accreditation of Healthcare Organizations tells Eli. "That's absolutely on the agenda."

Rush to Accreditation May Be Premature

PAOC member Dave Kazynski of VGM also emphasized the importance of moving forward on the quality standards, which he calls the "key to success" for bidding. Those standards need to be set before CMS moves ahead to test competitive bidding in 10 large metropolitan statistical areas in 2007, he points out.

In discussing the importance of standards, Kazynski uses the analogy of bidding on a government-funded road project. Transportation officials don't simply ask for bids on 10 miles of road, he notes. Instead, they specify whether the road is to be concrete or blacktop and the standards to which it must be constructed.

"It's kind of the same thing for this industry," Kazynski says. "Providers want to know what they are going to be required to do before they can adequately determine whether they even want to bid."

Caution: Given the absence of definitive quality standards, misinformation has been circulating about accreditation requirements for home medical equipment providers, Popovich warns.

The Medicare Modernization Act that mandated quality standards for HME does not say suppliers will necessarily have to become accredited through one of the three main HME accrediting bodies, she points out. Besides JCAHO, those groups include the Community Health Accreditation Program and the Accreditation Commission for Healthcare."

What the legislation says is that HME providers are going to have to meet quality standards as promulgated by the secretary and determined by a national accrediting body or bodies," Popovich explains.

CMS could develop a set of standards, tell the national accrediting organizations to evaluate suppliers against those standards and then go through a process to figure out which accrediting bodies would be able to do that.

Editor's Note: Information about the upcoming PAOC meeting is at www.cms.hhs.gov/suppliers/dmepos/compbid/paoc.asp#meeting.