Patients Over Paperwork: Room for improvement for HME

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Friday, October 5, 2018

WASHINGTON – Much has been made of CMS’s plans to reduce the paperwork burden for healthcare providers, but what about for HME providers, specifically?

The agency’s most recent attempt was last month, when it released a proposed rule aimed at removing unnecessary, obsolete or excessively burdensome Medicare compliance requirements. The rule, however, focused on Part A.

“There was nothing in the rule for us,” said Kim Brummett, vice president of regulatory affairs for AAHomecare. “We have been working with the Provider Compliance Focus Group and have made many suggestions to them for reducing the paperwork burden.”

CMS has made some concessions, including loosening the proof of delivery requirement and removing the date stamp from the written order prior to delivery, but there’s plenty more that could be done, stakeholders say.

So what are the top areas where CMS could reduce the paperwork burden for HME providers?

Kim Brummett, AAHomecare

“More flexibility on physician orders. As an example: allow multiple PAP accessories to be on the same order when a patient uses different supplies over the course of a year.

“A fairly new requirement: that the liter flow of an oxygen patient needs to be documented in the medical record. Most times, this is documented on the order, not necessarily the medical record.”

Kelly Grahovac, the van Halem Group

“The diabetic shoe policy requires documentation showing that several criterion have been met, in addition to a comprehensive plan of diabetic care being documented by the physician treating the patient for diabetes. (That) is a lot.

“A walker is such an inexpensive piece of DME; however, if not documented properly, it will deny. The physician must document a mobility limitation that impairs the beneficiary from participating in one or more MRADLs in the home; and document the beneficiary can safely use the walker and the walker will improve the mobility deficit. (All) for a piece of equipment that is often purchased as a cash item.”