Plenty of HMEs say 'no thanks' to accreditation

WASHINGTON - Accreditation is too expensive, irrelevant, a waste of time and a problem to deal with on another day. So say providers who have yet to become accredited and don't plan to engage the process in the foreseeable future. While nearly three-quarters of those who are not accredited plan to ramp up this year, a significant chunk of the 405 respondents to March's HME NewsPoll are holding out against the costly requirement. Though providers summoned a myriad of reasons and some very strident feelings to explain why they weren't accredited, money was the bottom line for many. "With the proposed cuts, especially in oxygen, we could not afford to become accredited," said a supplier at Independent Oxygen in Arkansas. For pharmacists, especially, the costs are difficult to reckon. One pharmacist started down the accreditation road by selecting a vendor and writing a policy and procedure manual. But "after seeing the level of disruption and expense we were facing, we became skeptical," said Michael Odom, the DME manager of San Joaquin Drug in Planada, Calif. "As a small pharmacy with a DME department, we could not see how this one aspect of our business would support itself with such increased burdens." Robert Lautman felt the same way. "The cost of being accredited could never be made up by the meager reimbursements and problems associated with billing Medicare," said the president of Mill Pharmacy in Mt. Laurel, N.J. For other suppliers, the accreditation requirement is reason enough to revamp the entire business model. "We will drop Medicare and Medicaid (along with any other insurance requiring accreditation) once accreditation becomes mandatory," said Bob Sherman, manager of Valley Medical Supply in Stevensville, Mont. To make up lost revenues from Medicare and Medicaid, Sherman is expanding his Internet presence, as well as his retail showroom. As a provider of ramps, lifts and other equipment that Medicare doesn't pay for, David Lincer feels like he dodged a bullet when he built his business around payers other than Medicare. "The confusion experienced by the DME providers watching the regulations change/vary/disappear has me glad that we do not engage in that part of DME," said the owner of Rollin' Along in Hayward, Calif. Other suppliers hope to keep ducking and weaving as they idle beyond the pale of this year's competitive bidding or hole out in rural areas where, maybe, nobody cares. There was no shortage of strident retorts to the NewsPoll. Dave Norton bypassed accreditation because he believes the for-profit accreditors are catering to large national suppliers and, consequently, putting unnecessary financial burdens on his company, PDS Medical in Lawrence, Kan. Nancy Gillis thinks the costs of accreditation are prohibitive and that those who require it should also pay for it. "Why should we be lining the pockets of private accreditation companies?" said the president of Calais Home Care in Calais, Maine.