PHOENIX, Arizona (July 14, 2021)—Home medical equipment providers may need to wait as long as a year before the situation is back to normal on Philips Respironics CPAP devices, which have been put on hold due to a nationwide recall, according to the American Association for Homecare.

“The reality is, we’re probably not going to get this market disruption fixed for 8-12 months,” AAHomecare president Tom Ryan said Wednesday. He was giving the organization’s update at Medtrade West in Phoenix, where the recall, which was announced June 14, was a frequent topic of conversation.

Ryan said that that AAHomecare’s board met with Philips leadership in Phoenix and has also been reaching out to payers, Medicare and the Food and Drug Administration to find answers. The board also met with leadership at ResMed, the other major CPAP producer.

He said that the timing of the recall is particularly unfortunate for home medical equipment (HME) providers, who were already told in April that CPAP production was delayed due to the global microchip shortage and other supply chain issues. And that bad news came after CPAP sales were depressed during the pandemic, as sleep labs limited operations and patients were hesitant to come in for fittings.

“We were facing a problem and this just made it much, much worse,” Ryan said.

Ryan and his team normally offer their update twice a year at each session of Medtrade, but the last was held in March of 2020 in Las Vegas just before the pandemic hit the United States.

Ryan exuberantly praised the providers in the audience and around the country who stepped up to provide essential services during the pandemic, including caring for discharged patients at home, adapting to serve vulnerable populations safely and preventing “a disaster” of hospital overflow.

“You’ve been shining through this pandemic,” he said. “If you think about what’s been going on, there’s been a light shining on this industry like never before, and you rose to the challenge.”

One of the largest topics was the Durable Medical Equipment, Prosthesis, Orthotics and Supplies competitive bidding program, which is now on hold. The AAHomecare team said that, while they wanted to slow the move toward a new bid due to the stresses of the pandemic, there is now concern that the HME industry will lose ground on a number of wins that have been negotiated if CMS goes back to the drawing board after announcing that the prior program had insufficient cost savings. Meanwhile, providers are left with an outdated fee schedule even as they experience the economy-wide increase in costs for materials, shipping and more.

“Everything’s been disrupted—you can see it in the rental car industry, you can see it at Home Depot—and we’re sitting here with six-year-old rates,” that were set by a “failed bid program” Ryan said.

The advocacy group is working on legislative and regulatory alternatives; meanwhile, Vice President for Regulatory Affairs Kim Brummett said it seems unlikely that a bid program would launch in 2024 as planned unless CMS releases its final rule soon.

Other priorities include:

  • Making permanent that 50/50 rate and a 25/75 rate for nonrural areas that will expire when the public health emergency (PHE) ends
  • Working to eliminate sequestration, which will cut into reimbursement rates if it kicks in in 2022 if expected, triggered by the $1.9 trillion relief package
  • A proposed national coverage determination for oxygen, which Brummett said includes both positives—including extending home-based oxyten to acute conditions like pneumonia—and challenges, such as giving DME Medicare Administrative Contractors (DME MACs) more discretion. Comments on that are due August 1.
  • Expecting audits to rev back up in the coming months after a pause during the pandemic
  • Working with states to set limits on and improve oversight of managed care organizations