It s 2007 Mandatory Accreditation is Here Are You Prepared Wednesday, April 25, 2007 MedTrade Spring

Presentation Transcript

It's 2007! Required Accreditation is Here! It is safe to say that you are Prepared? Wednesday, April 25, 2007 MedTrade Spring Mary Ellen Conway President

Overview What is the accreditation necessity? Who are the perceived accreditation suppliers? At the point when do YOU should be prepared? Initial 10 MSA's, Next 80 First Ten Products for Bidding Final Quality Standards Inconspicuous Items" Concerns

Overview Continued Clarifications Every Organization's " Must Haves " Accreditation decisions tips to use in your choice How would you begin? Audit of the Final Quality Standards Review of the perceived Accreditation Providers Ten things you can do now to be prepared

What is the Accreditation Requirement? The Medicare Modernization Act of 2003 (MMA '03) states that ALL DME Providers charging Medicare for distinguished Part B items must be certify by 2007 - this will be authorized at first through the Competitive Bidding Requirement January 26 declaration repealed BUT TODAY???

The "Dominos" CMS is implementing the law that requires focused offering in 2007 (Now April 2008) Only licensed associations can present an offer and "contend" in the offering procedure Accreditation must be by "perceived" accreditors Provider must conform to Final Quality Standards (Released 8-14-06)

Who Are the Recognized Accreditors? … And then there were ten… Changed January 2007 JCAHO NB of A for Orthotic Suppliers CHAP CARF HQAA BOC ACHC NABP ABC of O&P The Compliance Team

When Does Competitive Bidding Begin and Where? Aggressive offering "takes off" in 2007 in 10 Metropolitan Statistical Areas ( MSA's ) and in 80 in 2009 Excludes New York, Chicago and Los Angeles in 2007 Only authorize suppliers can partake in focused offering

The First 10 MSA's Temporarily Listed on CMS Website at 9:00 AM 3/30/07 Charlotte-Gastonia-Concord: NC-SC Cincinnati-Middletown, OH-KY-IN Cleveland-Elyria-Mentor, OH Dallas-FT Worth-Arlington, TX Kansas City, KS-MO Miami, Ft Lauderdale, Miami Beach, FL Riverside, San Bernadino, Ontario, CA Orlando, Kissimmee, FL Pittsburgh, PA San Juan, Caguas, Guaynabo, Puerto Rico

The Top 20 MSA's Were Charlotte Boston Miami Kansas City, MO and KS Riverside, CA Pittsburgh Phoenix San Francisco Cincinnati Atlanta Houston San Juan Dallas St. Louis Orlando Detroit Tampa Seattle Cleveland Philadelphia

Next 80 Largest MSA's Los Angeles New York Chicago San Diego Washington, DC St Louis, MO/IL Richmond, VA Louisville Nassua/Suffolk Oakland, CA Denver Newark, NJ Portland, OR Ft Worth, TX Las Vegas San Jose, CA Ft Lauderdale Indianapolis San Antonio Virginia Beach Columbus, OH Milwaukee Bergen, NJ New Orleans Salk Lake City Greensboro, NC Austin Nashville Providence. RI Raleigh/Durham Hartford Buffalo Middlesex/Somerset Memphis W Palm/Boca Monmouth Jacksonville Rochester, NY Grand Rapids Fresno

Next 80 Largest MSA's Con't Oklahoma City Greenville, SC Dayton, OH Honolulu Albany Tucson Tulsa Ventura, CA Syracuse Omaha Albuquerque Akron Knoxville El Paso Bakersfield Gary, IN Allentown, PA Harrisburg Scranton Toledo, OH Jersey City Baton Rouge Youngstown, OH Springfield, MA Little Rock Ann Arbor Stockton, CA Wichita Charleston New Haven, CT Mobile, AL Columbia, SC McAllen/Edinburg, TX Sarasota/Bradenton

keeping in mind the end goal to offer in the first round You should be authorize by August 31 st ! Implies: Survey booked by early-mid July Work through all procedure through May/June NOT MUCH TIME!

The MSA Uses US Census Data Applies to characterized Zip Codes where the recipient dwells , not where the supplier is found Was barring Mail Order in the First Round, yet now incorporates just diabetic supplies by means of mail request

When Do You Need to Be Ready? On the off chance that you give any of the recognized items or administrations to Medicare recipients in any of the initial 10 characterized ranges and wish to proceed with, you will be required to offer. So as to offer, you should be authorize. On the off chance that you give items and administrations to Medicare recipients in such regions as who are NOT in the initially characterized benefit ranges, you might be required to take an interest in Competitive Bidding in 2009 (80 MSA's distinguished for Competitive Bidding in 2009) All mail arrange begins in 2009 in the First 10 MSA's and the resulting 70. All others are required to be certify (regardless of whether there is Competitive Bidding in your administration region) as right on time as 2009-2010—TODAY"S ANNOUNCEMENT

What on the off chance that You Provide Products and Services in Rural Areas Only? You may never need to take an interest in Competitive Bidding You will get a rate change as CMS will repay suppliers the rates paid in the nearest MSA's You should be certify by some date-no limited date discharged yet. CMS consultative discharged Friday, January 26 (CR 5415 Transmittal 188) revoked

Current Legislative Activity Tanner Hobson (some time ago Hobson Tanner) www.aahomecare.org Advocacy Updates Also: Price Repeal of 36 mo Oxygen Cap (H.R. 621)

Final Product Categories Oxygen Supplies and Equipment Standard Power Wheelchairs, Scooters and Related Accessories Complex Rehab Power Chairs and Related Accessories Mail Order Diabetic Supplies Enteral Nutrients, Equipment and Supplies CPAP, RAD's and Related Supplies and Accessories Hospital Beds and Related Accessories Negative Pressure Wound Therapy Pumps and Related Supplies and Accessories Walkers and Related Accessories Support Surfaces (Groups 2 and 3 beddings and overlays) in Miami and San Juan just

Product Selection CMS chose items for CB in light of: High cost High-volume Greatest potential for investment funds

Final Quality Standards Were discharged on 8-14-06 !!! 14 pages—when contrasted with 104 in September 2005 VERY MINIMAL contrasted with proposed measures however don't be tricked! Found on the CMS site at: (http://www.) cms.hhs.gov/CompetitiveAcqforDMEPOS/04_New_Quality_Standards.asp Compliance with these benchmarks will be upheld through the accreditation supplier you select

Final Supplier Quality Standards 2 Sections First Section: Business Services Administration Financial Management Human Resource Management Consumer Services Performance Management Product Safety Information Management

Final Supplier Quality Standards Second Section: General Product Specific Service Standards Preparation Intake Beneficiary Record Delivery and Set-Up Training/Instruction to Beneficiary and Caregiver Follow-up

Final Supplier Quality Standards Appendix A-C A: Respiratory Equipment, Supplies and Services Oxygen concentrators, stores, high weight chambers, oxygen embellishments and supplies, oxygen preserving gadgets Home obtrusive mechanical ventilators CPAP Devices Respiratory Assist Devices IPPPB Devices Nebulizers

Final Supplier Quality Standards Appendix A-C B: Manual Wheelchairs, Power Mobility Devices, Complex Rehab and Assistive Technology Key Issues in Complex Rehab and Assistive Technology: Check things recorded Employ no less than one qualified RTS per area Provide proper hardware for trial Provide private, perfect and safe rooms suitable for fitting and assessment Maintain a repair shop situated in the office

Final Supplier Quality Standards Appendix A C : Custom Fabricated, Custom Fitted, Custom-made Orthotics, Prosthetic Devices, Somatic, Ocular and Facial Prosthetics and Therapeutic Shoes and Inserts Not off-the-rack things

Final Standards Administrative 1. Gets and supplies fitting quality hardware, things and administrations 2. Have a physical area and show all licenses, authentications and grants 3. FDA affirmed things and acquire duplicates of components, guarantees and directions 4. Conform to Medicare strategies (scope, claims handling, installment approaches and exposure of proprietorship) Example: Disbarment List www.oig.hhs.gov/extortion/exclusions.html 5. Actualize business practices to avoid and control misrepresentation, waste and mishandle 6. Utilize strategies that well-spoken benchmarks of direct that guarantee consistence with appl. laws and regs. 7. Assign leader(s) in charge of consistence issues

Final Standards Financial Management 1. Actualize budgetary administration rehearses that guarantee precise bookkeeping and charging. 2. Exact, finish and current budgetary records 3. Money or gathering based bookkeeping 4. Interface gear to customer 5. Oversee incomes and costs on a progressing premise: Reconcile accuses of solicitations, receipts and stores Operating spending Mechanism to track genuine incomes and costs

Final Standards Human Resource Management Implement arrangements on: Specific capabilities Training Experience Continuing training prerequisites Technical faculty: Competent Licensed, confirmed or enrolled (and current duplicates on document)

Final Standards Consumer Services Provide clear guidelines on utilize, support and potential risks of item(s) Provide expected time allotment for receipt of conveyed item(s) Verify thing/administration was gotten Provide contact data and choices for rental or buy Provide data and phone numbers for client help: Regular business hours, night-time, repair, crises

Final Standards Performance Management Implement execution administration arrange for that measures results of client administration, charging rehearses and unfriendly occasions. At the very least, measure: Beneficiary fulfillment and grievances Timeliness of reaction to inquiries, issues and concerns Impact of business practices on ampleness of recipient access to things, administrations, data Frequency of charging/coding blunders Adverse occasions .:tslid