CMS Issues Quality Standards
On Aug. 14, the Centers for Medicare & Medicaid Services (CMS) issued quality standards for DME providers. The standards, part of the requirements of the Medicare Modernization Act, are vital to the National Competitive Acquisition program, which is slated to go into effect in 2007.
CMS also announced that it is seeking applications from accrediting organizations for Medicare Deemed Status.
Accreditation will be a priority for the first 10 MSAs to compete in competitive bidding in 2007. All remaining suppliers will be phased in.
On Sept. 26, 2005, CMS posted draft standards for a 60-day public comment period that ended Nov. 28, 2005. CMS received more than 5,600 comments. Based on the public comments, CMS made significant revisions to reduce the burden on small suppliers while ensuring quality services for beneficiaries.
The new quality standards reflect basic good business practices and product specific services, according to CMS. The expectation is that many suppliers already comply with the quality standards and have incorporated these practices into their daily operations. Some key revisions include:
- Eliminated unnecessary specificity and redundant information and reduced the standards from 104 pages to 14 pages.
- Modified overly prescriptive requirements to focus more clearly on providing reliable quality service to beneficiaries. For example, CMS eliminated the requirement to be open for 40 hours per week and replaced it with a requirement to maintain posted business hours.
- Clarified requirements for performance management to allow suppliers flexibility in determining indicators related to their products and services.
- Consolidated and incorporated certain product specific standards into the general product-specific service standards, reducing the number of product specific standards from 15 to three. The product specific standards are designed to ensure that beneficiaries receive the right equipment, training and education to meet their needs.
Callers to the Open Door Forum on Aug. 15 voiced concerns over the missing data for competitive bidding, namely the timetable for the release of the 10 MSAs and what suppliers should be doing about accreditation until that time; the number of accrediting agencies CMS would select to handle the volume of suppliers; and the AARC guidelines in appendix A of the quality standards.
Some accrediting bodies have said that suppliers should not wait until the MSAs are announced, but go ahead and start the accreditation process now. Those same accreditation organizations indicated that as soon as quality standards were released, they would submit their applications for Medicare Deemed Status.
The likely accrediting agencies include the Accreditation Commission for Health Care Inc. (ACHC), the Community Health Accreditation Program (CHAP), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), The Compliance Team, the Healthcare Quality Association on Accreditation (HQAA), and ABC/BOC, the prosthetics and orthotics group.
The date the quality standards go into effect is still to be determined, pending the release of the 10 MSAs. The final rule on competitive bidding is expected later this year.
View the quality standards on the CMS Web site at www.cms.hhs.gov/CompetitiveAcqforDMEPOS/04_New_Quality_Standards.asp.
For more information on competitive bidding, check out the September issue of Home Health Products.
This article originally appeared in the July 2006 issue of HME Business.