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Just a start

Just a start

In the past few months: 

  • A global pandemic has severely stressed the supply of oxygen concentrators, revealing cracks in an HME industry that has been slowly chipped away at by Medicare’s competitive bidding program for 10 years. 
  • CMS has decided not to move forward with the majority of Round 2021 of that program, because the agency didn’t “achieve expected savings,” and therefore – wait for it – the current reduced rates continue to apply. 
  • The government failed to uncover until recently a Medicare fraud scheme that involved a provider listing his yacht captain as a director for a shell company he created to submit false claims. 

Sorry, we just can’t enough miles out of that last one. 

There’s rarely a scarcity of news in the HME industry (something that really wows people outside of the industry), but the past several months have had a certain punch to them, haven’t they?  

I was reminded of just how much is going on in the HME industry during a recent conversation with Ronda Buhrmester, senior director of payer relations for VGM Government Relations. 

“Suppliers are so busy right now – I really feel for them,” she said, while talking about how providers are trying to keep up with what’s allowed during the public health emergency, like coverage for any respiratory related devices for any medical reason determined by clinicians. 

“They have so much being thrown at them right now, whether it’s the (PPP) loans, the stimulus package, the bid program, the lack of equipment,” she said. “Then there are the issues with their own employees and having to deal with a virtual workforce. They’re telling me, ‘We can’t keep up; we don’t know if a rule has changed or not,’ and finding the answers is never easy.” 

This is the day-to-day for providers – big and small. Of the difficulties of meeting increased demand for oxygen concentrators, Dan Starck, CEO of Apria Healthcare, said: “It’s not just the smaller providers. We’re moving equipment around the country every day.” 

There’s been a lot of talk about how the pandemic has shown the larger health care industry and beyond just how critical it is to have a healthy HME industry, especially as it relates to ensuring access to ventilators, oxygen concentrators and other respiratory related devices. 

And I 100% agree. 

But I also think there should be talk about what goes into making that HME industry healthy – because it’s not the status quo.  

Provider Regina Gillispie, in a recent Q&A with Medtrade Monday, said that during a recent fundraiser she told Sen. Shelley Capito, R-West Va., “My drivers and my respiratory therapists are in these homes and we need the affordable PPE just like the hospitals do.” Capito mentioned in her speech during the fundraiser the importance of providers being able to deliver in the home and how important they are in freeing up hospital beds. 

Stakeholders like Gillispie have to master a political dance that wouldn’t allow them to say this, but I’ll say it: You know what allows providers to be in homes, making deliveries and keeping people out of hospitals, safely during a pandemic? PPE, which we know they’re having trouble affording, best case scenario, and sourcing, worst case scenario. 

You can’t agree that the HME industry is important without also supporting policies and reimbursement that make it solvent. 

That’s why I like recent efforts by stakeholders like AAHomecare and VGM to collect information about supplier costs, and why I like efforts by the Council for Quality Respiratory Care to make permanent certain waivers and other changes that have been allowed during the PHE. 

In my mind, everything’s on the table now, and that’s just a start. 


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