<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2007-11_06/06-01.jpg" hspace="4" vspace="4" /> Most readers are aware that in an effort to limit fraud and abuse, <sup>1</sup> Congress has directed the Centers for Medicare & Medicaid Services (CMS) to sharpen requirements to bill Medicare. Primary among those requirements is that practitioners must be certified or licensed to provide covered services, and the billing facility - the supplier - must be accredited by a CMS-approved agency. In other words, an agency that CMS has granted deemed status. CMS has carefully examined a number of accrediting agencies, and the Board for Orthotist/Prosthetist Certification Inc. (BOC) is one of just ten that have been awarded deemed status. This means that CMS will accept BOC facility accreditation as evidence that you qualify to bill Medicare. Since the accreditation process takes time (think months rather than weeks!) to prepare policies, assemble documents and other requirements, and for the accrediting body to both review and conduct an on-site survey of your facility, you should be getting in line now. Although we do not have exact numbers, estimates are that about 140,000 vendors may be required to be accredited in the next several years. Considering that there are only ten accrediting bodies, this is a huge number to evaluate. Let me emphasize this fact: When the CMS mandate kicks in, you will not be able to bill Medicare unless your accreditation is in place. Deadlines are being phased in, and the first ten Metropolitan Statistical Areas (MSAs) have been announced. <sup>2</sup> It may be surprising to some, but the majority of facilities - even in the initial MSAs - have not begun the accreditation process. If your facility is in one of these MSAs, you should be working on your accreditation application now. The next group will be announced sometime in 2008, and it is predicted that the balance of the country will follow along much faster. BOC reports solid market share in this early stage of requirement, indicating early acceptance. <h4>What to Look for in an Accrediting Agency</h4> Here are some basic criteria to follow when selecting an accrediting agency. The agency's programs should be designed to meet the needs of the beneficiaries of services first, and not a perceived need to aggrandize either the practitioner or the practice site. The program should be versatile and user-friendly. An accrediting agency's programs should be designed to meet rigorous standards necessary to provide care with appropriate safeguards to patients, prescribers, and payers of care. The agency should understand the needs of injured, infirm, or otherwise vulnerable patients. Just as you should hold your accrediting agency to a high standard, the accrediting agency should also set a high standard for your facility and require that it meet performance standards in all areas of practice - not only by the credentialed practitioners but also the entire facility staff. And finally, the accrediting agency you choose should be reasonably priced, both in the initial costs as well as maintenance fees. The process should be detailed but not difficult. The BOC accreditation program was designed by teams of credentialing experts, facility owners/managers, practitioners, prescribers, and representatives of the public to meet these standards. Included in this group were representatives of small and medium-sized practices. I suggest downloading an application and listing the details you will need to accumulate. Most items, such as insurance and policy manuals, are in hand although some organization of materials will be required. If problems arise, the BOC office stands ready to help. Good luck, but do not procrastinate. The time to act is now - for real! <i>Donald Fedder is president emeritus of the Board for Orthotist/Prosthetist Certification Inc. (BOC) and a professor of pharmacy and medicine at the University of Maryland, Baltimore. For more information about BOC accreditation, visit </i><a href="https://opedge.com/92"><i>www.bocusa.org</i></a> <h4>References</h4> <ol style="margin-top: 0px;"> <li>See OEI-03-07-00150. March 2007. In unannounced visits of 1,561 facilities in South Florida, 45 percent failed to meet one or more of five Medicare standards.</li> <li>The initial ten Metropolitan Statistical Areas (MSAs): Charlotte-Gastonia-Concord, North Carolina/South Carolina; Cincinnati-Middletown, Ohio/Kentucky/Indiana; Cleveland-Elyria-Mentor, Ohio; Dallas-Fort Worth-Arlington, Texas; Kansas City, Missouri/Kansas</li> </ol>
<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2007-11_06/06-01.jpg" hspace="4" vspace="4" /> Most readers are aware that in an effort to limit fraud and abuse, <sup>1</sup> Congress has directed the Centers for Medicare & Medicaid Services (CMS) to sharpen requirements to bill Medicare. Primary among those requirements is that practitioners must be certified or licensed to provide covered services, and the billing facility - the supplier - must be accredited by a CMS-approved agency. In other words, an agency that CMS has granted deemed status. CMS has carefully examined a number of accrediting agencies, and the Board for Orthotist/Prosthetist Certification Inc. (BOC) is one of just ten that have been awarded deemed status. This means that CMS will accept BOC facility accreditation as evidence that you qualify to bill Medicare. Since the accreditation process takes time (think months rather than weeks!) to prepare policies, assemble documents and other requirements, and for the accrediting body to both review and conduct an on-site survey of your facility, you should be getting in line now. Although we do not have exact numbers, estimates are that about 140,000 vendors may be required to be accredited in the next several years. Considering that there are only ten accrediting bodies, this is a huge number to evaluate. Let me emphasize this fact: When the CMS mandate kicks in, you will not be able to bill Medicare unless your accreditation is in place. Deadlines are being phased in, and the first ten Metropolitan Statistical Areas (MSAs) have been announced. <sup>2</sup> It may be surprising to some, but the majority of facilities - even in the initial MSAs - have not begun the accreditation process. If your facility is in one of these MSAs, you should be working on your accreditation application now. The next group will be announced sometime in 2008, and it is predicted that the balance of the country will follow along much faster. BOC reports solid market share in this early stage of requirement, indicating early acceptance. <h4>What to Look for in an Accrediting Agency</h4> Here are some basic criteria to follow when selecting an accrediting agency. The agency's programs should be designed to meet the needs of the beneficiaries of services first, and not a perceived need to aggrandize either the practitioner or the practice site. The program should be versatile and user-friendly. An accrediting agency's programs should be designed to meet rigorous standards necessary to provide care with appropriate safeguards to patients, prescribers, and payers of care. The agency should understand the needs of injured, infirm, or otherwise vulnerable patients. Just as you should hold your accrediting agency to a high standard, the accrediting agency should also set a high standard for your facility and require that it meet performance standards in all areas of practice - not only by the credentialed practitioners but also the entire facility staff. And finally, the accrediting agency you choose should be reasonably priced, both in the initial costs as well as maintenance fees. The process should be detailed but not difficult. The BOC accreditation program was designed by teams of credentialing experts, facility owners/managers, practitioners, prescribers, and representatives of the public to meet these standards. Included in this group were representatives of small and medium-sized practices. I suggest downloading an application and listing the details you will need to accumulate. Most items, such as insurance and policy manuals, are in hand although some organization of materials will be required. If problems arise, the BOC office stands ready to help. Good luck, but do not procrastinate. The time to act is now - for real! <i>Donald Fedder is president emeritus of the Board for Orthotist/Prosthetist Certification Inc. (BOC) and a professor of pharmacy and medicine at the University of Maryland, Baltimore. For more information about BOC accreditation, visit </i><a href="https://opedge.com/92"><i>www.bocusa.org</i></a> <h4>References</h4> <ol style="margin-top: 0px;"> <li>See OEI-03-07-00150. March 2007. In unannounced visits of 1,561 facilities in South Florida, 45 percent failed to meet one or more of five Medicare standards.</li> <li>The initial ten Metropolitan Statistical Areas (MSAs): Charlotte-Gastonia-Concord, North Carolina/South Carolina; Cincinnati-Middletown, Ohio/Kentucky/Indiana; Cleveland-Elyria-Mentor, Ohio; Dallas-Fort Worth-Arlington, Texas; Kansas City, Missouri/Kansas</li> </ol>