DMEPOS Enrollment vs. Accreditation: Is There a Difference?

By Brian Banks

There has been some confusion over whether DMEPOS enrollment is different from CMS accreditation. If a facility is enrolling as a DMEPOS supplier, does it need to go through the accreditation process too? Does accreditation have to happen before enrollment? Will there be one or two site visits?

The two processes are separate, and it’s important for suppliers to understand the differences.

The standards are different
First, DMEPOS supplier standards and Medicare Quality Standards are two separate sets of standards. Each set of standards relates to different aspects of a supplier’s business. Therefore, the two processes are not interchangeable. 

Second, two different groups are responsible for ensuring compliance with the two different sets of standards. The National Supplier Clearinghouse (NSC) is responsible for ensuring suppliers are in compliance with the DMEPOS supplier standards. The accrediting organizations appointed by CMS (such as ABC and BOC) are responsible for ensuring suppliers meet the Medicare Quality Standards.

Since the two processes and sets of standards are different, being in compliance with one set of standards does not ensure compliance with the other. A supplier’s accreditation does not automatically mean it has met the requirements to bill Medicare as a DMEPOS supplier.

What about site visits?
Suppliers are also confused about the number of site visits they’ll receive. Both the NSC and the accrediting organizations will conduct site visits or surveys to determine a supplier’s compliance with the set of standards each entity is responsible for enforcing. Therefore, suppliers can expect to receive a site visit or survey from both the NSC and an accrediting organization to verify compliance with their respective sets of standards.

The NSC’s role
Some of the confusion comes from the fact that the NSC is involved in the quality standards accreditation process. But the NSC’s involvement in the accreditation process is limited to ensuring suppliers are properly accredited to provide the products and services listed on the supplier file, and collecting and maintaining information regarding supplier accreditation.

What makes this even more confusing is that CMS has yet to establish a date when all suppliers must be accredited. Therefore, suppliers are not currently required to provide the NSC with their accreditation information or complete Section 2F of the CMS 855S application form. The NSC will inform suppliers when this information is required.

Please note, suppliers who are planning to participate in the first round of the competitive bidding process must be accredited or be pending accreditation to submit a bid. Also, suppliers must be accredited to be awarded a contract. The accreditation deadline for the first round of competitive bidding is October 31, 2007.

The different responsibilities
Below is a breakdown of each entity’s responsibilities, which should help clarify the differences between the two processes.

The NSC is responsible for:

• The DMEPOS enrollment process
• Ensuring suppliers are in compliance with DMEPOS supplier standards
• Maintaining information regarding supplier accreditation
• Performing site visits to ensure a supplier’s compliance with the DMEPOS supplier standards

Accrediting organizations are responsible for:

• Accrediting suppliers based on the Medicare Quality Standards for specific products and services provided to Medicare beneficiaries
• Ensuring suppliers remain in compliance with the quality standards
• Conducting site surveys to ensure suppliers are in compliance with the quality standards

Keep them separate
To reiterate: the NSC and accrediting organizations are enforcing two different sets of standards. Being in compliance with one set does not mean the supplier is in compliance with the other.

For more information regarding the DMEPOS enrollment process, please contact the NSC Customer Service Line at (866) 238-9652 or visit the NSC Web site (www.PalmettoGBA.com/NSC).

For more information regarding the accreditation process and the quality standards, please visit www.cms.hhs.gov/CompetitiveAcqforDMEPOS on the CMS Web site.

Brian Banks is NSC Ombudsman at Palmetto GBA.