Heartland: Signs ahead point to ‘growth’

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Friday, June 19, 2020

WATERLOO, Iowa – The HME industry has weathered its share of hardships and the current COVID crisis is no exception. But, as “first responders,” providers will get through this too, VGM’s Mark Higley said in the kick-off last week to Heartland at Home.

“You had challenges, supply shortages, the protocols are all different,” said Higley, vice president of regulatory affairs. “I acknowledge the decrease in elective procedures, but it’s my opinion there will be pent up demand—you’ll see some growth and growth in the valuation of your business.”

His remarks were made during the opening session, "HME in the Post-Pandemic Era: Analysis & Commentary.” The virtual event takes place June 15 through July 10, and features five tracks covering billing and reimbursement, business operations and leadership, respiratory, rehab and accessibility. 

As the industry moves forward, providers must maintain vigilance around payer requirements brought on by the pandemic. Many of those changes relaxed requirements for prior authorizations and face-to-face visits, allowed for telehealth visits and adjusted reimbursement rates, says Craig Douglas, vice president of payer and provider relations for VGM. But they probably won’t stick around.

“Most of these changes are temporary,” he said. “Payers could, in fact, decide on their own when to go back to normal. Keeping up may seem daunting, but if you don’t, you’ll end up with a mountain of denials.” 

If there’s one thing the pandemic has really driven home for the HME industry—and ideally, for CMS officials and lawmakers—it’s how important a link providers are in the health care continuum.

The industry needs to leverage that to get Round 2021 of the competitive bidding program delayed or halted altogether, says John Gallagher, vice president of government relations for VGM.

“When they are contacting the winners and sending out contracts, that’s when the next COVID wave comes,” he said. “That’s the time they will need capacity and they will need the providers to meet demand.”

While lawmakers have indicated they would prefer to see the program addressed through regulatory channels, stakeholders are ready to go with legislation, says Gallagher.

The Senate is expected to move forward with another COVID-related relief package in the next few weeks ahead the August recess.

“We need to get legislation in that final package so start reaching out,” he said.