Medicare alert on recall is ‘disappointing’

WASHINGTON – Medicare’s recent alert to beneficiaries on the Philips recall of certain CPAP devices resulted in a wave of repercussions for HME providers, including a rash of phone calls from upset patients. 

While technically correct, the alert made it sound like providers have repairs or replacements at the ready, when they don’t. Philips just announced on Sept. 1 that it has received approval from the U.S. Food and Drug Administration for its repair plans, and supply chain issues are severely impacting a provider’s ability to access replacements – not only from Philips but also other manufacturers. 

“It’s disappointing,” said Ronda Buhrmester, senior director of payer relations and reimbursement for VGM & Associates. “Suppliers are doing everything they can, so it’s disappointing that this is causing more tension and stress and frustration for them. Their phones are ringing off the hook with patients demanding new machines because of the notice.” 

The alert, which reportedly was also sent to beneficiaries who don’t even use CPAP devices, says: “If you would like to replace or repair your equipment, the supplier you bought the equipment from is responsible for replacing or repairing rental equipment at no cost to you when the equipment is less than 5 years old. If the equipment is more than five years old, Medicare will help pay for a replacement.” 

It’s true, says Andrea Stark, a Medicare consultant and reimbursement specialist for MiraVista, that providers are the “facilitators” of repairs and replacements, but Medicare should have provided context that the process will take months, if not up to a year. 

“There’s no immediate cure available,” she said. 

Buhrmester and Stark recommend that providers use the alert as another talking point to reassure beneficiaries that they’ve registered their devices with Philips and encourage them to also register with the company. 

“Suppliers need to affirm that they’re doing everything in their power and, hopefully, patients will be empowered by that message,” Stark said. 

Stark, for one, believes that CMS will “improve the messaging” around the recall going forward. 

“This is the difference between the policymaker, CMS, and the person who has to live with the policy, the provider,” she said. “I think it takes something like this to get them back to earth and in touch with what’s happening on the ground.” 

At least Medicare is clear from a policy perspective, Buhrmester says, which can’t always be said about private payers. 

“Other payers are up in the air – some are saying you can replace the machine, others aren’t responding to provider requests,” she said. “Some are saying they’re following Medicare, but they don’t know what that means, and providers have to educate them. It’s a checkerboard.”