Riddle me this HME provider whose name has been redacted


Industry attorney Asela Cuervo brought to my attention today a new OIG advisory opinion (11-08) that I managed to miss. Basically, an HME provider whose name has been redacted asked the OIG if it's OK that it pays IDTFs a fair market value to perform certain services related to setting up patients on CPAPs and educating them on its behalf.

For now, let's put aside all the other details of the relationship: that it applies only to non-Medicare patients; that the HME provider's products are featured in the facility of the IDTFs; that, despite its relationship with the HME provider, the IDTFs supply patients with a list of other providers.

And let's focus on this: If an HME provider pays IDTFs to set up patients on CPAPs and educate them, what's left for the provider to do?

Inquiring minds want to know.

Because I can't ask this HME provider whose name has been redacted, I asked Ceurvo.

She said: "I think that's what the OIG is thinking, too, although they didn't go out and say that. 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 they're doing this for you, they're 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 they're saying, 'This mask we provided you comes from DME supplier Joe, but there are all these other suppliers you can use, too,' there's that issue of, we're 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"?

Liz Beaulieu


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 DME's drop and run and an insult to those who work hard to keep patients compliant and healthy.

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