As part of its proposed rule for calendar year 2026 published in the Federal Register on July 2, the Centers for Medicare & Medicaid Services (CMS) detailed accreditation changes the agency wants for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) accrediting organizations (AOs).
Aside from increasing reaccreditation frequencies from three years to one year, CMS described new rules to increase its oversight of DMEPOS AOs.
In the proposed rule, CMS expressed concern that AO approval has not been reissued since 2006, when DMEPOS accreditation for suppliers billing Medicare began. CMS said it may may require AOs to submit reapproval applications. There are eight DMEPOS accreditation organizations, including the American Board for Certification in Orthotics and Prosthetics and the Board of Certification/Accreditation.
“Considering this nearly two-decade period, we believe it is imperative to commence a reapproval process for all current AOs as soon as possible after the effective date of any finalization of our proposals.”
AOs are given “some discretion in the operational aspects of its review of a supplier’s request for accreditation,” but that CMS was concerned “that differences between the AOs in this regard could lead to inconsistencies in how quality standard compliance determinations are made,” the proposal read.
CMS said that while surveys are often part of the accreditation process, not every DMEPOS supplier receives one, which leaves a potential vulnerability in enforcement of the DMEPOS accreditation requirement. CMS also proposed that companies applying to become AOs submit “a detailed description of the organization’s operational, survey, and other accreditation processes to confirm that the suppliers it accredits meet or exceed the DMEPOS quality standards and Medicare program requirements. We believe this expanded data would give us a broader understanding of the AO’s procedures in full, instead of those simply relating to operations.”
AOs would be required to:
- Explain its policies for avoiding conflicts of interest “involving individuals who conduct surveys or participate in accreditation decisions”
- “Describe its processes for identifying and correcting deficiencies within its accreditation program”
- Explain how it uses its data to ensure that its accreditation program conforms to Medicare requirements
- Share its processes for detecting and addressing instances of fraud, waste, and abuse by suppliers
- Report misconduct to CMS and law enforcement if applicable.
CMS would be able to order AOs to perform surveys of accredited suppliers at any time.
“We do not believe surveys should be restricted to initial accreditation and re-accreditation situations, especially considering the aforementioned three-year time gap between them,” the proposed rule said. “Suppliers must at all times be compliant with the quality standards and not merely upon initial accreditation and reaccreditation. To help verify that such adherence is consistently maintained, we believe we need discretion to direct an AO to conduct a survey at any given time.”
CMS acknowledged the cost burden associated with the proposed accreditation provisions.
“We project that it would exceed $128 million annually. We understand the financial impact this could have on the DMEPOS community. However, this would be more than offset by the over $660 million in annual savings to the Medicare trust funds and the taxpayers due primarily to the removal of fraudulent and non-compliant DMEPOS suppliers from the Medicare program.”
“We believe these changes would help better ensure that DMEPOS AOs closely oversee DMEPOS suppliers for compliance with the DMEPOS quality standards,” the proposed rule said.
CMS is seeking feedback about the proposal from AOs, DMEPOS suppliers, and other stakeholders. To comment, visit the Request for Information at cms.gov/medicare-regulatory-relief-rfi.
To read “Medicare and Medicaid Programs; Calendar Year 2026 Home Health Prospective Payment System (HH PPS) Rate Update; Requirements for the HH Quality Reporting Program and the HH Value-Based Purchasing Expanded Model; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Updates; DMEPOS Accreditation Requirements; Provider Enrollment; and Other Medicare and Medicaid Policies,” visit the Federal Register.
