HME Starts to Feel the Impact of COVID-19

As the world responds to the pandemic, HME organizations begin postponing events, AAHomecare seeks further guidance from CMS, and providers consider how to help protect vulnerable patients.

• By David Kopf
• Mar 12, 2020

As the World Health Organization officially labeled COVID-19 a pandemic today, the HME industry is starting to feel the effects of the disease as it impacts healthcare and daily life in the United States.

Federal and state agencies are starting to address the disease from a regulatory perspective, industry events are beginning to get postponed, and HME providers are working to determine how they should work with patients and other care professionals.

Coordinating With CMS

On the federal level, CMS released broad statements regarding how to work with patients and how to help keep staff safe from the disease using personal protective equipment (PPE). And the agency also released statements covering how to bill for COVID-19 testing and issues related to testing.

However, the HME industry works with various vulnerable groups such as seniors and long-term oxygen therapy patients and needs more specific advice. So, the American Association for Homecare is working with CMS to get more guidance on ways to address issues specific to HME when it comes to COVID-19:

• Relaxing Medicare requirements for chronic lung disease for the provision of home oxygen short term.
• The potential use of telehealth to meet Medicare requirements for face-to-face documentation and ongoing medical necessity.

“We need CMS relief as well,” said Tom Ryan, president and CEO of AAHomecare. “We need CMS to suspend adding non-invasive ventilators from Round 2021 of the competitive bidding program and to protect access to this critical therapy. It also needs to prioritize provisions of PPE for providers who are providing equipment and supplies to COVID-19 patients in their homes.”

Ryan added that CMS should allow coverage for short-term-use oxygen patients who will need to be treated with oxygen after being diagnosed with COVID-19. That would also include reduced paperwork burdens.

He added that the COVID-19 situation is another example of why CMS must continue relief in 2021 for rural providers and should give relief to non-bid, non-rural providers.

“CMS needs to keep this infrastructure of HME providers viable,” Ryan noted. “We are on the front lines!”

Additionally, AAHomecare’s regulatory staff and its Regulatory Council are meeting early next week to develop a list of priority regulatory issues and questions, and will then approach CMS with that list, according to Kim Brummett, vice president of Regulatory Affairs for the association.

“These include oxygen coverage for patients who do not have a chronic lung disease and a short term need; telehealth for face-to-face documentation for new setups and ongoing medical need requirements, obtaining proof of delivery and patient/caregiver signatures when they won’t open the door on delivery,” she added.

AAHomecare has collected various government and private payer COVID-19 resources at aahomecare.org/covid-19-resources. 

State Agencies

Similarly, state associations are beginning to communicate with agencies governing their providers. For instance, the Atlantic Coast Medical Equipment Services Association has been in touch with North Carolina, Virginia, and West Virginia Medicaid agencies and is passing along guidance and resources to their members.

To that end, North Carolina Medicaid hosted a webinar on March 12, “Medicaid Policies and Codes Related to COVID-19,” which covered policy modifications to help make it easier to provide services during the outbreak.

Also, ACMESA has two board members on a North Carolina Respiratory Care Board task force; a conference call with Virginia Medicaid slated for next week; and is coordinating with West Virginia, noted ACMESA Executive Director Beth Bowen.

Provider Preparedness

While official guidance comes into focus, on the provider side of things, many HME businesses are starting to shape their response in terms of how they work within their communities.

“We had a general staff meeting this week to review our infection control protocols, discuss the importance of strict adherence to using Universal Precautions, and implementing some temporary extra precautions for the foreseeable future,” said Stephen Ackerman, CEO of Spectrum Medical Inc. in Silver Spring, Md. “They cover a wide range of topics from doing your own dishes immediately in the kitchen, to asking customers if anyone in the house has a fever or has been recently outside the country prior to delivery. We are talking a lot to make sure information stays current and in perspective.”

In terms of advice for providers, AAHomecare underscored the need to minimize exposure while helping patients.

“The COVID-19 outbreak poses a unique threat to the safety of individuals in our industry and additional significant challenges if individuals needing care at home grows rapidly,” the association noted in a public statement. “We urge you to take careful precautions to protect yourselves and your colleagues from exposure so our industry can continue to serve the patients who depend on us — perhaps now, more than ever.”

Industry Meetings

Where industry events are concerned, some state associations are beginning to postpone their events. The Association for Tennessee Home Oxygen & Medical Equipment Services (ATHOMES) postponed its ATHOMES Spring Conference, previously scheduled for March 19-20 in Nashville, Tenn., to a “future date yet to be determined.”

Also, Northeast Medical Equipment Providers (NEMEP) Association announced that its annual conference and exhibit show, planned for April 1-2 in Tarrytown, N.Y., has been postponed due to concerns over the coronavirus.

Given the number of major and minor event closures and postponements, as well as school closures, and other event shut-downs across the nation, it is likely that more industry events might be postponed.