Frugality prevents resupply problems

‘We were never doing blanket resupplies’
Friday, July 12, 2013

YARMOUTH, Maine – A year after CMS caught the CPAP community off-guard with a change in the requirements for how supplies are replaced, providers say there hasn’t been much of an impact.

“It didn’t really affect us that greatly, probably because we never gave patients stuff they didn’t need,” said Glenn Steinke, owner of Airway Medical in Bishop, Calif. “It’s been beneficial to the patient to a certain extent because we need to see they are compliant.”

In June 2012, CMS began requiring providers to determine whether an item is no longer functioning before they can replace it. Without any guidance from the agency at the time the change was announced, providers worried that they’d run afoul of the rule. 

That hasn’t happened.

“We just added more criteria and more questions and more documentation,” said Lisa Feierstein, president and co-founder of Raleigh, N.C.-based Active Healthcare. 

Providers who use an automated system for supply reorders say they took a similar approach.

“With the automated system, the patient answers the right prompts to say they need the supplies and that kicks it over to a real person,” said Eric Parkhill, vice president of clinical operations/corporate compliance for Home Medical Professionals in Gainesville, Ga. “We have a very straight set of questions that we use to ask patients to pinpoint what’s wrong with it.” 

As far as any impact on their bottom lines, providers say that, too, has been negligible.

“It may have decreased minimally, but because we never were doing blanket resupplies there wasn’t as big of an impact,” said Feierstein. “I would think the place where there was a big effect was where resupplies were sent out without conversation.”



This ruling of course would only have a significant impact on those suppliers who engaged in re-supply practices to send out new supplies at the exact replacement allowed time.  With all the aggressive auditing, these suppliers would have to know this sends out a welcome mat for QIC's.