Post-PHE environment could be complicated

YARMOUTH, Maine – Respondents to a recent HME Newspoll were nearly evenly split on whether or not they’re prepared to operate in a post-PHE environment. 

A slight majority, 52.63%, reported they’re not prepared, particularly with a 75/25 blended Medicare reimbursement rate for providers in non-rural areas set to expire along with the PHE. 

“Rates are already too low to cover costs,” wrote one respondent. 

CMS in September pointed to an eventual end to the PHE with the release of an overview titled “Creating a Roadmap for the End of the COVID-19 Public Health Emergency” that summarizes the waivers still in place and those that have expired.  

What worries respondents most about the PHE ending is not only the end of the blended rate (23%) but also the end of the waived coverage criteria and face-to-face requirements for respiratory therapy (7.69%) and the signature/proof of delivery requirement (15.38%). 

“We have lost so much over the past several years – fewer patients due to the older generation not leaving home as much and lost profit from increasing supply chain costs and employee wages,” wrote one respondent. “Taking away the exceptions will just make more work for suppliers, which will result in a burden on top of all the other burdens that still exist from the pandemic fallout.” 

For some, overshadowing these worries are the potential audits they face for serving patients under the waivers. 

“There is little trust to what Medicare will have us do with existing patients that were accepted under the PHE,” wrote Lee Guay, a director at Fairview Home Medical Equipment in Minnesota. 

The 47.37% of respondents who reported they’re prepared to operate in a post-PHE environment say they continued to operate as if the PHE and the waivers didn’t exist.  

“We did not take advantage of the PHE easing rules,” wrote one respondent. 

The PHE is expected to be renewed through mid-January.