Editor's Note

Coping With COVID-19

As the country stays at home and engages in social distancing, the HME industry starts shaping its response to a pandemic that threatens many vulnerable patient groups.

• By David Kopf
• Mar 19, 2020

The beginning of March was a strange time for travel. The week of March 8 marked both Medtrade Spring in Las Vegas and the International Seating Symposium in Vancouver, and my journey quickly took on an odd tone. My flight from Orange County, Calif. to Sin City had 14 people on it. The Vegas airport was empty, and I had my pick of the taxis, rather than waiting in a Disney-like line at the cab stand.

It wasn’t until HMEB sales manager Rick Neigher and I had our booth set up at the Mandalay Bay Convention Center that we noticed the adjacent casino and resort were pretty empty. When I flew Wednesday night from Vegas to LAX and then up to British Columbia, it finally dawned on me that COVID-19 had hit North America. And by the time my Friday trip home was in complete disarray due to the consolidated flights, my wife was texting me photos of empty toilet paper shelves at the local grocery store.

Roughly a week later, it felt like an entirely different world. The NCAA canceled its 2020 tournament. SXSW and Coachella had postponed. Princess Cruises had suspended operations. The entire country of Italy was on lockdown. The World Health Organization declared COVID-19 a pandemic and Pres. Trump declared a National Emergency so that healthcare funding can more freely flow to Medicaid programs to bolster front-line testing and care.

Now, three weeks later, various counties across my home state of California are issuing either shelter-in-place or stay-at-home declarations, and now, as I write this, it looks very likely that Gov. Gavin Newsom will announce a statewide stay-at-home declaration. [Update: he did just that.] As a telltale indication that Federal response is now starting to flow to the states, a few flatbed tractor-trailer rigs delivered some Army National Guard vehicles to the federal building near my home.

The Impact on HME

Not surprisingly, COVID-19 is directly impacting the home medical equipment industry. For starters, after CMS released broad statements earlier this month regarding how to work with patients and how to help keep staff safe from the disease using personal protective equipment (PPE), the American Association for Homecare immediately began working with CMS to get more guidance on ways to address issues specific to HME. This included:

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

“We also 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,” Tom Ryan, president and CEO of AAHomecare, told me. He 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.

Then, AAHomecare’s regulatory staff and its Regulatory Council developed a list of priority regulatory issues and questions, according to Kim Brummett, vice president of Regulatory Affairs for the association. Those items were put into a lengthy letter and sent to CMS this week. At the top of the list: 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.

Helping to take of the fight to get PPEs for HME providers, VGM & Associates called on HME providers to contact state and local health officials to ensure they get priority access PPE supplies since they are assisting homecare patients.

Where industry events are concerned, some state associations started postponing 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, the Northeast Medical Equipment Providers (NEMEP) Association announced that its annual conference and exhibit show, planned for April 1-2 in Tarrytown, N.Y., had been postponed due to concerns over the coronavirus.

On the provider side of COVID-19, many HME businesses are starting to shape their response in terms of how they work with patients and 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,” Stephen Ackerman, CEO of Spectrum Medical Inc. in Silver Spring, Md., commented to me in an email. “… We are talking a lot to make sure information stays current and in perspective.”

I don’t know where this is headed, but we have ventured into all-new territory, and many post-acute patients are the most vulnerable in terms of COVID-19. Fortunately, they have HME providers and this industry on their side.