‘Take the patient’ 

WATERLOO, Iowa – For HME providers, the need for information and confirmation on waivers related to the public health emergency has ebbed and flowed with surges in COVID-19 cases, says Ronda Buhrmester of VGM Government Relations. 

“Back in the spring, the hotspots were big cities and they were the ones dealing with the impact of the pandemic, while other areas were not,” said Buhrmester, senior director of payer relations. “Now providers in those other areas are wondering what they can and can’t do, because it’s also impacting them.” 

The result, Buhrmester says, has been a steady stream of questions around Medicare’s decision to cover respiratory related devices for any medical reason determined by clinicians during the PHE. 

HME News: So as long as we’re in a PHE, the current NCDs and LCDs that restrict coverage for these devices only to patients with certain clinical characteristics don’t apply, right? 

Ronda Buhrmester: Yes, I keep saying, “It’s OK to take the patient.” What I’m seeing is suppliers trying to do the right thing. They want to meet the policy requirements. They want to make sure they’re getting the CMN and getting everything signed by the patient. I think they’re in shock, and so they reach out and ask, “Are you sure it’s OK to take the patient?” It’s OK to take the patient. 

HME: What are you telling providers that helps put them at ease about taking on patients without, say, a signature or proof of delivery? 

Buhrmester: I tell them to set those patients up but that they’ll want to track them separately. Because you don’t know how long they’re going to need the equipment – is it shorter term or longer term – and you don’t know what’s going to happen later on. What happens post-PHE? Will those patients need to be requalified or will they be grandfathered? 

HME: It’s a lot to keep track of, even when they’re not in the middle of a pandemic. 

Buhrmester: Suppliers are so busy right now – I really feel for them. They have so much being thrown at them right now, whether it’s the loans, the stimulus package, the bid program, the lack of equipment. Then there are the issues with their own employees and having to deal with a virtual workforce. They’re telling me, “We can’t keep up; we don’t know if a rule has changed or not,” and finding the answers is never easy. They need the education and reassurance.