BATON ROUGE, La. (August 24, 2021)—Louisiana home medical equipment (HME) providers now have more protection against payment caps for home ventilation services.
The Louisiana state Senate voted unanimously to approve H.B. 594, The Protecting Home Oxygen & Medical Equipment Act, legislation that requires insurers, managed care organizations and other payers to reimburse ventilators on a continuous monthly rental basis without capping payments at the device’s purchase price. The state House of Representatives voted 84-14 in favor of the act in May.
The American Association for Homecare (AAHomecare) and Louisiana HME stakeholders advocated for the removal of proposed amendments that could have capped costs for non-invasive ventilators and restricted HME suppliers’ ability to provide important service and maintenance for specialized products.
“It’s really about ensuring access to care for those users and those with the complex medical needs that benefit from ventilation therapy,” David Chandler, senior director of payer relations for AAHomecare told local news station KPLC.
Like other states, Louisiana has seen a spike in COVID-19 cases, with a seven-day average of nearly 5,000 new infections. The state boasts a 40% vaccination rate. Some COVID-19 long-haulers require additional home ventilation. The state has seen a 37% decline in HME providers since 2013. Out of the state’s 64 parishes, there are 29 parishes that don’t have a traditional HME supplier, and 47 parishes don’t have a ventilator provider. Chandler marks this legislation a win.
“In the last decade, we’ve seen 44% reduction in supplier locations [across the country],” Chandler told KPLC. “If payments are capped during a period of medical need, then providers may be forced to discontinue care. Legislation like this will ensure that there’s adequate reimbursement for providers to stay in business and expand their business and expand their product offerings for patients, especially those with complex medical needs.”
The law took effect Aug. 1, 2021.