CMS Open Door Forum: Suppliers Nearly Out of Time to Get Accredited

Pharmacies may be at particular risk due to late start

One of the major messages that the Centers for Medicare & Medicaid Services (CMS) had for Open Door Forum participants on July 29: If you aren't well into the accreditation process by now, you're probably not going to make the Sept. 30 deadline.

That message was especially aimed at pharmacies that sell DME and want to continue to bill Medicare for it come Oct. 1. A significant number of pharmacies, CMS said during the call, had only recently started the accreditation process.

CMS representatives repeatedly said during last Wednesday's conference call that they'd announced the accreditation requirement to DME suppliers in 2006. But many pharmacies had hoped, till relatively recently, that they would be declared exempt from the accreditation requirement.

CMS did declare exemptions for some professions - including physicians, occupational therapists, physical therapists, and prosthetists -- that bill Medicare for relatively small amounts of DME. But pharmacies did not receive an exemption.

In addition, a substantial number of traditional DME suppliers also waited to start the process and are now racing the clock.

Said CMS' Sandra Bastinelli, "If you submitted a completed accreditation application to the accrediting organization by Jan. 31 of this year and you had minimal findings or no findings to correct (prior to) your on-site survey, CMS would ensure you that you will receive an accreditation decision on or before Sept. 30."

But Bastinelli reminded conference call participants that the accreditation process takes six to seven months to complete.

"If you're just applying now, please do not contact us and ask where you are with your Oct. 1 deadline," she said. "You will not, most likely, get accredited by the Oct. 1 deadline.... If you submitted a complete accreditation application to an accrediting organization after Jan. 31, we cannot ensure that you will receive an accreditation decision on or before the Oct. 1 deadline."

She added, "Regarding the pharmacies (and) a timeframe for accreditation: It is not any different than anyone else getting accredited" - even though, she said later in the call, many pharmacies had turned in accreditation applications as recently as July.

In related announcements, CMS' Nannette Hardouin said, "We expect that the National Supplier Clearinghouse, the NSC, will be sending letters to all suppliers that do not have a surety bond or an accreditation on file. It is the supplier's responsibility to make certain that all your locations and your information is accurate with the NSC and that they match the information that you have given the accrediting organization. Please update your 855, your enrollment application, if you have not done so already."

Hardouin also clarified the accreditation process and definition itself, saying, "You are either accredited or you are not. There is no such thing as partial accreditation or 'lite' accreditation."

Bastinelli asked suppliers going through the accreditation process to refrain from calling CMS or the accrediting bodies to ask when on-site surveys would take place.

"The on-site surveys are unannounced," she said. "You can be assured that your date is between now and probably the middle of September."

The company hosting the Open Door Forum said 561 people called in to listen. The next Open Door Forum is scheduled for Sept. 16.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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