AAHomecare: HME Needs Fair Reimbursement Rates Given Inflation

PHOENIX, Arizona (April 7, 2022)–Rising costs of materials, shipping, labor and gasoline will continue to hurt home medical equipment (HME) providers, especially if Washington won’t raise reimbursement rates, advocates and experts said at Medtrade West this week.

“Capitalism is such that the demand is greater than supply, you can do one thing, you can raise the prices—clearly we can’t do that,” Tom Ryan, president and CEO of the American Association for Homecare (AAHomecare), said at the organization’s update session at the show, held April 4-6 in Phoenix, Arizona. He said that shipping prices are up as much as 2,000%; polycarbonate materials used in HME are up 60%; and some providers have paid $1,000 per month just to buy personal protective equipment for employees entering patients’ homes.

“We need help, and we’ve got to go to the Hill to get that,” he said.

Efforts in Washington right now are focused on gaining support for HR 6641, the DMEPOS Relief Act. It would set a 90-10 blended reimbursement rate—that is, about 90% on bid pricing and 10% on the 2015 fee schedule—for the 13 categories dropped from the competitive bidding program, which Ryan and others said is imperative given stagnant reimbursement levels and increasing costs and surcharges.  

Jay Witter, AAHomeCare’s vice president of xx, said they expected to be able to announce new sponsors within days. That would be important because adding more sponsors makes it more likely the legislation would be attached to a larger package for passage later this year.

At the same time, there’s an equally important focus in the Senate on relief for competitive bidding beyond the end of the public health emergency (PHE), Witter said.

There was also much discussion at Medtrade about just when the PHE will end. Although the current round expires in July, many suspect it will be extended past the November mid-term election, stretching it as far as January. Meanwhile, HME providers should be pushing their legislators to look at making some of the CARES Act waivers permanent.

Other priorities include:

• Extending relief for HME in sequestration
• Allowing complex rehab technology (CRT) wheelchair users to upgrade to lighter materials, such as titanium and carbon fiber
• The Better Wound Care Bill, which looks at negative pressure therapy

In general, Ryan said, the performance of HME providers during the pandemic, has positioned the industry well to make a case for its value in the health care continuum. Now it’s just a matter of getting the word out. 

“There’s been a realization that patients want to be cared for in the patient-preferred setting, which is the home,” he said. “People didn’t want to go to the nursing home, they want to be at home. It set us up for a value proposition: This is where people want to be.”