Accreditation:

How to Reapply for Accreditation

Sponsored by: The Compliance Team

• By David Kopf
• Jul 01, 2010

Try to recall the summer of 2009. Less than a year ago, providers were scrambling to ensure they had CMS accreditation for DMEPOS and were desperate to find a spot on one of the accrediting organizations’ long lists of HMEs seeking to get accredited before the September deadline. It seemed as though the entire industry was trying to become accredited, and nearly every accrediting organization was able to ensure its providers obtained accreditation by the deadline.

So it might seem strange to learn that there are many providers still seeking to reapply for CMS accreditation. Why is that, and how do providers approach reapplying for accreditation?

Changing Ships

A common scenario for needing to reapply for accreditation is if a provider decides to change accrediting organization. Depending on how long a provider has been accredited, a new accrediting organization might have emerged since the provider originally obtained its accreditation, and the provider might decide that it prefers that newer accrediting organization standards to its current accreditor’s.

Since CMS accreditation fist became required and providers originally sought to make CMS’s deadline back in 2009, accreditation has undergone a makeover in terms of how providers perceive it. Instead of being just a means to an end in terms of Medicare funding, now providers view accreditation as a competitive edge, since a good program can put in place business practices that give it an edge in the homecare marketplace.

So it’s not surprising that with more choice between unique standards programs, providers might decide to obtain new accreditation.

Also, how an accrediting organization is set up and what how it works with providers can be a determining factor in whether or not a provider decides to change its accrediting organization. For instance, a larger, more corporate-style HME might prefer to work with a similar accreditor, while a smaller provider might prefer to deal with a less formal organization.

Likewise, every accrediting organization has different timetables in place in terms of how accreditation is maintained. One might have a three-year term, and another might have a one-year term. Also, cost and fee structures come into play when deciding whether or not to renew with an accrediting organization. So, when it is time for a provider to “re-up” with its current program, it might start looking for an alternative.

Other New Applications

And, while we often hear about the difficult funding environment in homecare, there are still many new providers entering the business, seeking accreditation. And of course, providers that missed CMS’s deadline would have had to pull their NSC number and apply almost as if they were a new business, given that they must become accredited before they can reapply for their number.

Another reason for reapplication is that a provider might not have passed its original attempts at accreditation with another organization, and has opted to work with a different accreditor instead. Or, there might be another reason why the agency didn’t pass the accreditation, such as for not meeting payment protocols. In this case, it is important to note that many accrediting organizations reviewing an application from a provider that previously worked with another accrediting organization will often as to see that prior accreditor’s report denying that provider accreditation before accepting the application.

Process

Once the provider decides to reapply for accreditation, it must then work with the new accrediting organization to obtain accreditation. From this point, the process becomes more standard: the provider will review the accrediting organization’s standards; begin adapting that organizations procedures and standards to its business; begin implementing all those procedures; and then go through the site survey.

However, it is important to note that transition from accreditation program to another might require some shifts in procedure and process depending on the accrediting organization’s standards. And in the cases of where there has been a failed prior accreditation, then the new accreditor might apply a more hands-on process in working with that provider to ensure success this time around. And in fact, that might even be desired by the provider that is re-applying for accreditation, since it wants to ensure success.

Bottom line: regardless of the reason for reapplying, it pays for the provider that is reapply to do its homework to ensure a good fit between the accrediting organization and its needs.

This article originally appeared in the July 2010 issue of HME Business.