Accreditation Investigation

I am the owner of a DME billing and consulting company. I have worked with multiple Suppliers and Accrediting bodies over the past two years in particular. Our company made sure our Suppliers were well trained and prepared for Accreditation. And, for the most part, I had no problems with Suppliers or the Accrediting bodies. However, I cannot understand the fiasco we have seen taking place.

A part of me blames Suppliers who have known for over two years about mandatory accreditation and did nothing to prepare, thinking they could “throw something together” at last minute. They are without excuse and truly don’t deserve an extension.

Another part of me, cannot believe the accrediting bodies who have think they don’t have to make surveys or follow guidelines and can get by with collecting big bucks, or have CMS turn a blind eye to their antics! This is dishonest and unfair to the Suppliers who worked for months and months and to the accrediting bodies that held high standards and maintained them. To have signed on and done the work as a Supplier and not have been surveyed a year or more later, or to not be able to reach my accrediting body by phone…NO WAY! There would be heads rolling!

Most Suppliers were hard working and honest, doing whatever to get the job done. I had only one Supplier that brought me in for one “additional” day of training under the pretense of being almost ready for survey. The truth from his staff was they had no training; his policy and procedure manual was greatly lacking, and he, later, asked me to sign off on things he did not have or know. I clearly told the man he was not ready for accreditation, his ethics were the kind our industry was trying to avoid and I would not help him in what most honest suppliers took a year or more to accomplish. Needless to say, I left and never looked back!

As far as Accrediting Bodies, the “Interpretation of Standards” often varied with the staff; some surveyors took two days, while some only two hours (?). Finally, I was offered a job as a Surveyor while I was consulting with their clients. They didn’t see a problem with it, but it screamed CONFLICT OF INTEREST” to me and I quickly declined! I did, however, wonder why Accrediting bodies did not hire extra surveyors, train them and send them out to the stragglers who signed up late, but were ready for survey before the deadline. In that instance, they could have even charged an expediting fee.

How to unravel this mess is almost mind boggling to me! Much like CMS/NSC enrollment failed to eliminate fraud, and legitimate suppliers suffer the consequences and blame, it seems the same thing has happened again. Did CMS not research and screen these accrediting bodies? Are they not held to their own set of standards and ethics? Is there money under the table between these agencies? What’s the deal? Honest, legitimate supplier suffer to the tune of losing Supplier numbers, staff losing jobs, patients neglected and falling through the cracks….where will this end? It is past time that the industry as a whole stops being the fall guy! Our government is accountable the Accreditation problems and the fraud and abuse that continues.

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