Lack of clarity pervades re-supply rule, according to NewsPoll

Friday, August 10, 2012

YARMOUTH, Maine – Most providers say CMS's new re-supply rule is "about as clear as mud."

Sixty-three percent of the respondents to the latest HME NewsPoll say they don’t have a good understanding of the rule, which requires providers to prove that re-supply items like CPAP masks are non-functioning before they replace them. The biggest unknown: a clear definition of non-functioning.

"Although I hope we do have a good understanding, it is not completely clear what CMS wants us to document," said Sally Johnson, manager at Cuyahoga Falls, Ohio-based Klein's Orthopedic & Medical Equipment.

Most of the confusion revolves around how providers are supposed to get information from patients on how their equipment and supplies are functioning and how to document that information in a way that CMS will accept.

CMS has promised an FAQ with clarifications, but with the rule already in effect, providers are doing things like creating scripts and forms to help with documentation.

"We are looking at developing a worksheet to document patient need and the condition of the supply, including the patient's perception and issues," said Jeanie Stoke, director of Anderson, S.C.-based AnMed Health Home Care.

Adding insult to injury, 69% of respondents to the poll say the rule will hit them in the wallets, because they expect to provide fewer supplies. One not-so-obvious reason for that: Patients will no longer have the luxury of keeping spare supplies on hand in case of emergencies.

But the biggest concern, respondents say, remains the possibility that the rule will result in sub-par therapy. They point out that paying to replace supplies more frequently is less expensive than treating the illnesses that may develop as a result of using the same supplies for too long.

"If masks and cushions are changed less frequently, it will invariably allow these items to harbor more pathogens and, in turn, increase the frequency of respiratory infections," said poll one respondent.