COVID-19 Response: AAHomecare Asks CMS to Change Key Policies

In order to help HME providers better serve patients during pandemic, industry association asks agency to change coverage and documentation requirements. At the top of the list: a requirement waiver for respiratory equipment and a one year competitive bidding delay.

• By David Kopf
• Mar 19, 2020

The American Association for Homecare has sent a letter to CMS calling on the agency to change Medicare coverage and documentation requirements in order to help HME providers continue serving patients during the COVID-19 pandemic.

Outlined with the help of the association’s Regulatory Council, the association’s recommendations include a number of changes designed to streamline regulatory requirements and make work safer for HME professionals.

At the top of the list is a one-year delay of competitive bidding Round 2021 implementation so that HME businesses can provide ready access to patients needing home oxygen therapy devices and services, as well as home ventilators.

AAHomecare is also asking CMS to:

• Waive chronic respiratory disease coverage requirements for respiratory equipment, medications, and supplies when a patient is diagnosed with COVID-19 or has other acute respiratory conditions during this pandemic. 
• Relax documentation requirements so that the standard written order is the only documentation needed during the pandemic.
• Allow alternatives for proof of delivery.
• Extend the expiration date of written orders for nine more months beyond the expiration date for recurring medical supply orders and ongoing DME rental claims.
• Allow ATP specialty evaluations required for certain power wheelchairs to be conducted via video.
• Waive the face-to-face requirement for new setups and ongoing documentation of continued medical need when the prescriber can’t document the encounter via telehealth.
• Suspend the Medicare supplier standard related to minimum hours of operation and physical access to facilities during the COVID-19 pandemic. Instead, CMS would let HME providers use mobile phone numbers in lieu of primary business telephones, and suspend site inspections to let HME provider employees focus on increased patient care needs.
• Prioritize provisioning personal protective equipment (PPEs) for suppliers who are providing DMEPOS to COVID-19 patients in their homes.
• Designate DMEPOS suppliers as “essential services” to ensure delivery to quarantined areas.
• Suspend all audits from DME MACs, RAC, and SMRC contractors to let suppliers focus on emergency activities.
• Allow ongoing equipment rental and supply provision to be paid to suppliers when patients are admitted and the hospital requests they bring their own equipment/supplies due to potential hospital shortages.
• Continue the extension of the current 50/50 blended payment methodology for DME items and services provided in rural areas.

AAHomecare’s full letter, which provides more detail on each item, can be read at bit.ly/2xdWoEJ.

AAHomecare added that it is continuing to engage CMS and other major payers, state Medicaid authorities, and legislative champions to advance other industry policy priorities.

“Our recommendations are focused on policy changes that will allow us to provide care that reduces the strain on our healthcare infrastructure in the near term; streamline regulatory requirements in light of the challenges of serving patients in the current environment; and provide longer-term stability for our industry,” noted AAHomecare President and CEO Tom Ryan in a public statement. “Most importantly, our recommendations will also support safer working conditions for HME professionals. AAHomecare and other stakeholders in this industry are committed to making sure our people are as well-protected as possible under these difficult and even dangerous conditions.”