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For More Information on the Accreditation Fees and Steps, please click here,
Listed below are the NBAOS accreditation requirements related to business structure, documents and policies and procedures for the facility considering accreditation. Each requirement is based on the quality standards mandated by CMS.
Business Structure
- Located in the United States or its territories
- Currently operating as a business entity
- Office locations must have: physical location with street address, telephone # accessible through directory assistance, exterior signage, posted hours and days of operation, state/local business permits, annual fire inspection
- Clean, organized and safe working conditions
- Articles of Incorporation (copy of official document)
- Federal Tax ID # (copy of official document)
- Comprehensive Liability Insurance Policy (minimum $300,000) (copy of official document)
- National Supplier Clearinghouse (NSC) document identifying DMERC # by office location [for existing suppliers with DMERC #]
- Identify individual(s) in leadership positions
- Organizational chart
- Disclosure of ownership
- NBAOS Affirmation of Compliance form signed [Note: the requirements are listed below]
- Current financial statement - by location
- Current year annual operating budget - by location
- Agendas/minutes – minimum one board meeting a year
- Compliance Officer (or more than one compliance officer) for billing, risk management, compliance plans
- Safety Officer
- Provider license, certification or registration to practice in state – current and in good standing for each provider
Documents
- List of pre-fabricated orthoses dispensed through the supplier
- Manufacturer guidelines, instructions and warranties for pre-fabricated orthoses dispensed through the supplier
- Provider personnel files (including contract and prn providers) with the following information:
- Job description
- Application/resume/CV
- State mandated document to practice (registered/certification/license) current and in good standing
- Orientation program – written
- Competency training
- Policy and procedure manual for the facility
- Continuing education
- Medical testing required by law (e.g. TB tests, Hepatitis B)
- Corrective action plan – for disciplinary issues (where applicable)
- Policies and procedure guidelines for providers
- Patient Information & Instruction Form
- Patient Satisfaction Survey – conducted a minimum of annually, with a summary report of the survey findings
- Beneficiary Compliant Form
- Written Performance Improvement Plan
- Equipment Safety Check List
- Beneficiary Injury Report Form
- Written infection control guidelines (developed by supplier or from the CDC)
- Electrical equipment inspection – equipment utilized for orthotics (copy of inspection with signature of inspector and date of inspection)
- Marketing material - accurately reflects business practices [Note: It is not a condition of accreditation to have marketing material. If a supplier does have existing marketing material, the marketing material must accurately reflect the business practices of the supplier]
Policies and Procedures (P&P)
- Policies & Procedures (P&P) for the prevention of fraud, waste and abuse (i.e. related to risk management, billing, patient satisfaction surveys, compliance plans, etc.)
- Compliance officer – billing related: ≥ two hours/yr training for the compliance officer regarding medical documentation, billing & coding or ethics
- Compliance officer – billing related: annually train providers on properly billing clinical services
- Chart audit annually – five charts to determine if orthoses dispensed are documented in the patient chart and billed appropriately
- Chart audit annually – five charts to ensure providers are performing proper chart documentation by including the information outlined in the following bullet point
- P&P - documentation includes: physician orders, evaluation, diagnosis/injury/medical condition/surgery, pertinent medical history, short and long term goals, treatment plan, follow up visits or discharge as appropriate and services rendered
- P&P - billing representative - reviews and documents billing and coding errors a minimum of annually
- P&P - receipts issued to beneficiaries
- P&P - handling beneficiary complaints
- P&P - returning beneficiary phone calls
- P&P - written safety program
- P&P - handling beneficiary injuries
- P&P - disaster preparedness plan
- P&P - fire drill - minimum of one time a year
- P&P - tornado/hurricane drill - minimum of one time a year
- P&P - arrangements with alternative supplier should supplier not be able to provide services to beneficiaries (e.g. disaster, power outage)
- P&P - handling of hazardous waste and blood soaked dressings
- P&P - HIPAA guidelines
- P&P - locked medical records
- P&P - guidelines for providers related to patient care
- P&P - patient education regarding proper application, use, troubleshooting, cleaning, maintenance and safety of orthoses dispenses
- P&P - on-site and/or off-site continuing education for providers - eight hours per accreditation cycle
- P&P - abide by definition of terms in the CMS product specific quality standards (appendix C) for orthotics and prosthetics
- P&P - pre-fabricated orthoses evaluated for safety and manufacturer guidelines
- P&P - advising beneficiaries cost to repair, replace, adjust or change an orthosis
Affirmation of Compliance
The facility has identified an authorized representative to affix a legally binding signature to assume responsibility, on behalf of the facility, for the accuracy and truthfulness of the completed application and survey.
Outlined below are conditions required by CMS to serve as an accredited supplier for durable medical equipment, prosthetics and orthotic supplies (DMEPOS). The facility legally authorized representative must carefully review and sign the Affirmation of Compliance document in order to proceed with the survey and application process. The document includes the following conditions of participation:
- The supplier states full compliance with Medicare regulations and policies and Medicare contractor policies and articles.
- The supplier states full compliance with Medicare coverage, claim processing, and payment policies.
- The supplier shall disclose audits by Medicare (within the past 12 months or since the last accreditation) and provide copies of compliance requirements or repayment requirements.
- The supplier shall comply with 1834 (h) of the Social Security Act addressing “Payment for Prosthetic Devices and Orthotics and Prosthetics”.
- Current DMERC suppliers have active NSC supplier numbers on file with the National Supplier Clearinghouse, form 855S – DMEPOS, as of the date of this survey.
- The supplier shall complete and provide copies of the Medicare Disclosure of Ownership and Control Information requirements at 42 CFR 420.210 through 420.206.
- The supplier complies with all CMS Quality Standards and those quality standards identified in appendix C (Custom-fabricated, custom-fitted, custom-made orthotics, prosthetic devices, somatic, ocular and facial prosthetics, and therapeutic shoes and inserts).
- The supplier shall conform to necessary revisions in the accreditation requirements, policies and/or procedures as mandated by Medicare or deemed necessary by NBAOS and shall acknowledge receipt of the changes within the stated deadline.
- The supplier shall inform NBAOS of new office locations or changes in office locations (ownership/address/closings/etc.) within 30 days of the change.
- Once accredited, the supplier shall remain in compliance with each of the requirements of CMS and NBAOS as outlined in the application and survey requirements.
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