Accreditation Resource Center

NHIA Reimbursement Training Center

Welcome to the NHIA member resource center on accreditation where we provide educational and reference materials on accreditation, certification, and other verification programs that apply to home and specialty infusion organizations and clinicians. Check back periodically for updates.

In order to provide services to Medicare beneficiaries under the Part B Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) benefit, infusion companies must comply with Quality Standards established by the Centers for Medicare & Medicaid Services (CMS).  These standards were established under authority of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) and became a requirement under the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) effective October 1, 2009.

CMS has granted “deeming authority” to 10 accrediting bodies, six of which have accreditation programs in place for home infusion pharmacy. While the achievement of DMEPOS accreditation is a recognition of compliance with Medicare Standards, it does not reflect all of the elements of full accreditation, such as care planning, home nursing services and performance improvement activities.  Nonetheless, by requiring this step as a condition of Medicare participation, CMS established a new industry baseline and DMEPOS accreditation became virtually universal within the home infusion world.   Here are a few links to basic information for DMEPOS suppliers:

Tools and Resources
Medicare DMEPOS Quality Standards and Accreditation embersonly 

Accreditation programs are intended to validate the quality and consistency of home infusion services against defined standards of care. Over the past 30 years, voluntary accreditation as a “verification” of organizational performance has evolved with the changing health care marketplace, and is in many ways a basic requirement for doing business. The factors that continue to drive health care to the non-acute setting—concerns over patient safety, clinical effectiveness, and cost containment—are contributing to an increased demand for provider verification.

Click here to access the September/October 2015 INFUSION Magazine article titled “The Current State of Accreditation in Home and Specialty Infusion: A look at the standards and drivers in the changing alternate-site marketplace” for an overview of the forces at play in the accreditation and certification arena as of 2015.

Click here to see a snapshot of accrediting bodies and programs in the home and specialty infusion space and the service areas they cover.

Click here to see NHIA’s 2015 Home Infusion Accreditation Program Matrix, which provides a full overview of each accrediting body, programs offered, standards, fees, timelines, and more (edited for consistency and formatting).  To access the extended, unedited program information provided by each accrediting body, click on the names below:

No longer are the core requirements of simple pharmacy licensure and accreditation sufficient, as market forces continue to influence the regulatory and reimbursement environment for home and specialty infusion services. New regulations and requirements are beginning to appear—and will continue to do so. In addition, the business climate is evolving in such a way that providers who wish to demonstrate sophistication in delivering high-quality, patient-centered care as they pursue new business lines and partner with new players will likely need to exceed the traditional core competencies that have been at the foundation of the home infusion industry.  Here are a few examples of programs developing in our market:

Sterile Compounding Verification

Patient Safety Standards-Oriented Accreditation

 

Integrated Care Certification

Individual Clinical Practice Certifications