Eli's Rehab Report

Published on Mon Nov 24, 2008 PDF

If you've been sweating over the new accreditation requirements for durable medical equipment, orthotics, prosthetics, and supplies starting in September 2009, you can relax.

CMS recently decided that physicians and other healthcare professionals, including rehab therapists, would no longer have to pursue these accreditation requirements before obtaining a supplier number from the National Supplier Clearinghouse, the American Occupational Therapy Association (AOTA) reported in a special notice on its Web site.

CMS held a Special Open Door Forum on Sept. 3 to address providers' concerns and to clarify language in the Medicare Improvements for Patients and Providers Act regarding DMEPOS accreditation. MIPPA section 154(b) added a new subparagraph (F), stating that eligible professionals and other persons are exempt from meeting the Sept. 30, 2009, accreditation deadline until CMS determines that the quality standards are specifically designed to apply to such professionals and other persons. MIPPA also states that CMS may exempt such professionals and persons from the quality standards based on their licensing, accreditation, or other mandatory quality requirements that may apply -- which is just what CMS did for physicians and therapists.

"This is a huge victory for patients and healthcare professionals across this nation," said American Physical Therapy Association President R. Scott Ward, PT, PhD. "These unnecessary requirements would have been overly burdensome, costly, and could have created obstacles for patients needing these services."

To be exact, accreditation costs could range from $2,000 to $5,000 over a three-year period, according to AOTA. "At this time, CMS stated that they are not planning to design specific accreditation standards for occupational therapists [or PTs and SLPs], although they have the regulatory authority to do so at any point in time."

Meanwhile, if you've been denied an NSC supplier number because you did not meet the DMEPOS accreditation requirements, resubmit your application to the NSC, CMS advised.

Careful: The National Association of Independent Medical Equipment Suppliers (NAIMES) opposes the exemptions, the trade group said in a letter to CMS. "The mandatory accreditation requirement [is] a vital element in the fight against fraud, abuse, and billing errors in DME." Indeed, the move exempts more than 45,000 National Supplier Clearinghouse-listed suppliers from the requirements.

"Exempting nearly half of the holders of supplier numbers goes against the intent of Congress," NAIMES argues. "These exemptions open another avenue for fraud that should be closed."