An HME provider is the complete package

Monday, July 25, 2011

I think its worth highlighting a comment to one of my blogs about a recent OIG advisory opinion criticizing arrangements between DME providers and sleep labs whereby the DME provider pays the sleep lab to perform certain services related to setting up patients on CPAP devices and educating them.

The question I posed in my blog was: If an HME provider pays sleep labs to set up patients on CPAPs and educate them, whats left for the provider to do?

Because I cant ask the HME provider who requested the opinion and whose name has been redacted, I asked industry attorney Asela Ceurvo.

I think thats what the OIG is thinking, too, although they didnt go out and say that, she said. The OIG is thinking, the DME supplier is paying the IDTF to do its work for it. And on top of that, the OIG is thinking, by virtue of the fact that theyre doing this for you, theyre acting as your spokesman and that can be an abusive marketing situation. Because the patient has presumably been (at the IDTF) for several hours, they know the staff and maybe even the doctor. If theyre saying, This mask we provided you comes from DME supplier Joe, but there are all these other suppliers you can use, too, theres that issue of, were making one supplier look better than all of the others.

So the HME provider pays someone else to do its work and gets free marketing? Ever heard of the phrase If it seems too good to be true, it probably is?

Robert commented:

Huh? Maybe this is the same reason Medicare thinks competitive bidding is a good idea. It is clear that neither understand how much work is involved before set-up, and in supporting the patient after therapy is dispensed. The actual set-up is a small fraction of the total time spent helping patients get on therapy and stay compliant. I am surprised and disappointed by this editorial posting. To feed into an opinion that all DMEs drop and run and an insult to those who work hard to keep patients compliant and healthy.

Looking back at my blog, I can see how Robert interpreted it that way.

I certainly didnt mean to imply that all HME providers do is drop and run. Few people outside of the industry know better than the staff of HME News all the work that HME providers do to care for their patients. Its our jobs to know these things.

I know that HME providers are often the first to recognize that a patient may have a sleep disorder.

I know that an HME providers job doesnt stop after a patient is set up on a CPAP device and educated on not only how to use it but also why its important to keep using it.

I know HME providers play an important role in making sure patients meet with their physicians between 31 and 90 days after beginning treatment, so theyre able to continue treatment.

I know some HME providers even organize support groups to help patients with sleep disorders.

But in my mind, if one removes the set-up and education from the equation, you dont have a provider of home medical equipment and services, you have a manager of patients. To me, an HME provider is the complete package.