While the home health final rule published Nov. 28 did not include some of the worst-case durable medical equipment scenarios, Tom Ryan, president/CEO of the American Association for Homecare (AAHomecare), said in a Dec. 15 industry webinar that serious potential damage remains possible.
“Yes, we may have destroyed the asteroid that was headed to Planet HME [home medical equipment], but let’s be clear — the fight is not over,” Ryan told stakeholders during the webinar. “The threat is still there out there, and it’s aimed directly at patient access.”
During the hour-long webinar, AAHomecare executives and industry leaders criticized the Remote Item Delivery (RID) process that seeks to whittle the number of suppliers providing, for example, urological supplies, ostomy supplies, and off-the-shelf braces. Currently, hundreds of suppliers serve Medicare beneficiaries in each of those product categories. The RID process could lower that number to fewer than 10 per category.
“This so-called RID category is nothing more than a consolidation scheme,” Ryan said. “It threatens to strip away choice, limit innovation and put patients at risk. We will not stand by while access is jeopardized to every stakeholder in these product categories. Know this: We are focused, relentless, back on the field with passion and a plan.”
Mina Uehara, senior director of regulatory affairs for AAHomecare, noted that the competitive bidding fact sheet — originally released on the same day as the final rule — was “later updated” by the Centers for Medicare & Medicaid Services (CMS) “to clarify that only new remote item delivery products will be included in the next round of bidding. So this means that legacy items, such as oxygen, wheelchairs and hospital beds, which were part of the previous competitive bidding rounds, will not be included.”
Webinar speakers later added that enteral nutrition and supplies are among the products excluded from the next bidding round.
But ostomy and urological supplies — as well as, possibly, tracheostomy supplies — are now in.
“And this is a significant change,” Uehara said. “It is important because medical supplies have traditionally been excluded from the competitive bidding program, and by redefining medical equipment to include these supplies, CMS is now creating a pathway for them to become eligible for competitive bidding moving forward.”
Kim Brummett, AAHomecare’s senior vice president of regulatory affairs, said the association is “compiling questions and clarifications” for CMS, including the question of if tracheostomy supplies are included — and how they will be included.
“I think the only option at this point would be for CMS to include [tracheostomy supplies] in the ostomy supplies product category,” said Cara Bachenheimer, an industry policy expert and shareholder at Brown & Fortunato. “The only reason we suspect that is because CMS, when they redefine their definition of items to be included, they basically say, ‘Tracheostomy supplies are just like ostomy supplies. So we don’t have to, in our regulatory text, separately identify them.’”
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