Home Health & Hospice Week

Reimbursement:

ROUND TWO BIDDERS SECURE ACCREDITATION BREATHER

Don't stick your head in the sand, CMS warns.

Despite Medicare's full-steam-ahead attitude on competitive bidding, suppliers are getting a slight break on round two accreditation requirements.

In the 70 metropolitan statistical areas that will make up competitive bidding areas starting in 2009, suppliers must have at least applied for accreditation by July 21, 2008 and must have received final accreditation by Jan. 14, 2009, the Centers for Medicare & Medicaid Services says.

Those deadlines are bumped from the original May 14 and Oct. 31 dates CMS set. "CMS is extending the deadline because a significant number of suppliers in those communities have not yet applied for accreditation," the agency says.

Suppliers may be holding off because CMS hasn't yet issued the specific zip codes for CBAs under round two. But delaying for that reason is a mistake, insisted CMS' Joel Kaiser in the May 13 Open Door Forum for home care providers.

The federal Office of Management and Budget defines the MSAs that CMS must use by law for bidding, Kaiser said. CMS has the authority to exempt low-volume areas from bidding, he acknowledged. But only "areas on the fringe that may be really low population" will be exempted.

Most MSAs' zip codes will be subject to round two, he said. The vast majority of suppliers are serving patients in the MSAs' high-population areas. "There's not much chance that those will not be part of the bidding area," Kaiser maintained.

Tip: To find out if your county is in the 70 round two bidding MSAs, go to
www.census.gov/population/www/estimates/metrodef.html, Kaiser instructed. Click on "counties with micropolitan and metropolitan statistical area codes" under the definition files, then download the most recent file and look up your MSA to see included counties.