Moving the HME Industry Forward

Legislative/Advocacy

Unsustainable HME Reimbursement Rates Add to the Challenge of Responding to Emergencies

Tom Ryan • October 2, 2017

WASHINGTON, DC – Recent hurricane activity over the last few weeks has given HME providers the opportunity to once again demonstrate exceptional dedication to their patients.  Many HME personnel have had to deal with damage to their own homes, barriers to travel, and other challenges getting operations going with limited or no power available, as well as difficulty in communicating with and reaching their patients at home or in shelters to deliver critically needed oxygen.

As we’ve reported these last few weeks, we’ve had very strong engagement with CMS to communicate what providers are dealing with and to advocate for waivers on documentation for replacement of lost or damaged products in areas affected by these disasters. CMS has implemented these policy changes quickly and has actively sought further input from AAHomecare and other HME stakeholders on making it easier for providers to serve their patients under these trying situations.

There is one policy recommendation that we haven’t been able to get buy-in from CMS on: reimbursement for oxygen tanks – a practice that would help both patients and providers a great deal in emergency situations. While CMS didn’t accede to this request for these emergencies, we will be advocating for change going forward.

Even with the documentation waivers and other welcome support from CMS in dealing with these challenging circumstances, the recent storms provide another example of how the bidding program and unsustainable reimbursement rates threaten the viability of the HME industry.

I faced challenging situations several times in my decades as an oxygen provider on Long Island, so I can certainly empathize with what many of our members and other HME providers are currently facing.  With reimbursement rates that already provide thin margins (or in many cases, negative ones as noted in last year’s HME Cost Study) on most HME products, providers have no way to cover the increased cost of serving patients under these conditions.  Deliveries are more difficult, personnel costs can go up as 12-16 hour days become the norm, and in some cases, there’s damage to operations or equipment that drives up cost.

The loss of lives and economic toll of Hurricanes Harvey and Irma have been devastating for Texas, Florida, parts of Georgia and Louisiana, the Virgin Islands and Puerto Rico, but the situation could have been far worse for individuals who depend on oxygen and other HME without a dedicated provider community ready to support them under these difficult conditions.  Without these efforts, the burden on first-responders, emergency rooms, and healthcare professionals would have been even greater.

The HME community must continue to make sure that patients, caregivers, medical professionals, legislators, and regulators appreciate the critical role that our profession plays in the healthcare infrastructure.  We’ll continue to make this a point of emphasis in our advocacy efforts, and we look forward to working with you all to highlight the essential work of HME under both clear skies and in the most challenging weather conditions.

Tom Ryan is president and CEO of the American Association for Homecare.