Thursday, April 30, 2009

Associated Press Outlines HME Communities Preparations for Swine Flu Pandemic

Apria Healthcare, a national home care provider of oxygen therapy and other durable medical equipment, recommended employees wear surgical masks when working in areas that have been impacted by swine flu, Executive Vice President Lisa Getson told the Associated Press. The company is also keeping N95 respirators for all employees dealing with patients showing symptoms of the swine flu.

Experts predict nearly 10 million patients could be admitted to hospitals and 1.5 million would need intensive care in a worst-case scenario. They also believe 750,000 people would need mechanical ventilators to continue breathing. This is a high end item provided by home care companies and one that may see high demand should things worsen. Mechanical Ventilators are primarily used to treat patients with severe lung injury, chronic pulmonary disease and neurological problems that disrupt. The devices use a tube inserted through the nasal passage to force air into the lungs.

The AP article titled Swine flu drives demand for face masks, mentions mechanical ventilator manufacturers Respironics as well as Cardinal Health. Cardinal Health’s spokesperson said, “it's too early to know if that will translate into a meaningful increase in actual demand." Last year the company sold 1,850 portable ventilators to New York Department of Health as part of its flu preparedness program.”

Currently in high demand is masks and other protective items, drugstore chains such as Walgreens and CVS has explained. While the Centers for Disease Control (CDC) has not recommended people wear masks claiming limited evidence that they are effective, the increase in sales has not faltered.

The CDC does suggest hand washing and covering one’s mouth when coughing or sneezing

The American Association for Homecare helped develop a guide for the durable medical equipment community to deal with a pandemic flu. View the text at

To read the full Associated Press article as published in the New York Times, please visit:

Monday, April 27, 2009

Swine Flu Outbreak Underscores Role of Homecare

The swine flu outbreak, which reportedly has spread from Mexico to several states in the U.S., is a vivid reminder of the key role of homecare in responding to a pandemic flu and importance of disaster planning for the home medical community. Health experts believe that a serious, pandemic flu outbreak is a question of “when” not “if.” On Sunday, President Obama declared a public health emergency, a step that puts federal resources in motion to deal with the outbreak of the swine influenza A (H1N1) virus.

Federal health officials in the United States place homecare at the center of a planned response to pandemic flu. In a pandemic event, hospitals will quickly be overwhelmed by a surge in patients and the vast majority of infected people will remain in their homes. Pandemic flu is defined as a virulent human flu that causes a global (pandemic) outbreak of serious illness. Because there is little natural immunity, the disease can spread easily from person to person.

“The nation’s infrastructure of home medical equipment providers represents a critical piece of any front-line response to pandemic flu,” said Tyler Wilson, AAHomecare president. The Association has also argued that home medical providers must be given first-responder status during emergencies when it is critically important to reach patients in their homes.

Two years ago, the American Association for Homecare participated, with the Centers for Disease Control and other federal agencies and with home health associations, in a two-day expert panel to advise the federal government about the role of homecare in a pandemic flu. The chief result of that panel is the publication, “Home Health Care during an Influenza Pandemic: Issues and Resources,” prepared by the Agency for Healthcare Research and Quality, which contains useful links to resources and detailed discussion of key issues related to planning, patient care, community and business response, legal questions, and workforce challenges. View the text at The report summarizes what homecare workers can expect during a pandemic:

“What to Expect During a Pandemic. In the event of an influenza pandemic, because of anticipated shortages of health care professionals and widespread implementation of social distancing techniques, it is expected that the large majority of individuals infected with the influenza virus will be cared for in the home by family members, friends, and other members of the community - not by trained health care professionals. Given these circumstances, home health care workers can expect to be called on to provide care for two main populations of patients:
• Those medical and surgical patients, not hospitalized because of the pandemic, who are well enough to be discharged early from hospitals to free up hospital beds for more severely ill patients.
• Patients who become or already are dependent on home health care services (predominantly elderly persons with chronic disease) and will continue to need in-home care during the influenza pandemic whether or not they become infected with the influenza virus.
• The demand for home health care services during a pandemic influenza outbreak is likely to exceed the home health care industry's current capacity to respond. Indeed, the overall surge capacity and preparedness levels of the home health care sector that will be necessary to respond effectively to a public health emergency such as pandemic influenza are significant unknowns.”

Also the main pandemic flu website is a good resource as well: Guidance for clinicians and public health officials can be found at:

Thursday, April 23, 2009

AAHomecare Offers Senators an Aggressive, Detailed Proposal to Stop Medicare Fraud

At a Senate hearing yesterday, the American Association for Homecare submitted a statement and issued a press release outlining the Association’s 13-point plan to stop fraud in Medicare. The statement reads, “Our legislative action plan is designed to protect these patients and their families—as well as the American taxpayers—by stopping fraud and abuse in the Medicare system before it can start. The plan targets fraud and abuse at the source through proposed policies that will ensure that providers who participate in Medicare are responsible, legitimate businesses and those disreputable actors are locked out of the system and prevented from abusing the public trust.”

The AAHomecare statement also said, “It is important to note that the American Association for Homecare welcomes a full and thorough review of reimbursement policies for durable medical equipment to ensure that Medicare payments reflect the true costs of providing home medical care to beneficiaries.” (See Newsroom at to view the full statement.)

Both Senators and government witnesses discussed steps to reduce waste and fraud in the durable medical equipment sector, unfortunately including the use of the “competitive” bidding program as an anti-fraud tool and a panacea for Medicare reform.

The hearing was conducted by the Senate Committee on Homeland Security and Governmental Affairs Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security.

The Centers for Medicare and Medicaid Services (CMS) testified that “CMS is pursuing a ‘stop-gap program’ to focus on Medicare fraud in seven high-risk areas across the country where CMS is increasing our oversight of the highest paid DMEPOS suppliers and the highest billed DMEPOS equipment and supplies. The ‘stop-gap program’ increases pre-payment reviews of medical equipment suppliers and will also single out the highest-billed claims–continuous positive airway pressure (CPAP) devices, oxygen equipment, glucose monitors and test strips, and power wheelchairs…. The plan toughens the background checks on new suppliers and increases scrutiny on the highest ordering physicians and the highest utilizing beneficiaries.”

Both the hearing and the OIG report underscore the sorry state of Medicare fraud prevention in the United States, which has had a tragic, adverse impact on the vast majority of home medical equipment providers who fully comply with the law and that provide high quality services to seniors and people with disabilities who require medical equipment and care.

Tuesday, April 14, 2009

Modern Healthcare Reports on HME Communities Request to Rescind Bidding Rule

Monday, the American Association for Homecare and 27 state associations sent letters to the Obama administration, Health and Human Services Acting Secretary, and Centers for Medicare & Medicaid Services Acting Administrator, urging them to rescind a controversial competitive-bidding rule on durable medical equipment before it is implemented on April 18.

Healthcare business news publication, Modern Healthcare, reported on the HME sector’s letter re-publishing sections including the statement “selective contracting with a small group of home equipment providers will force out 90% of existing businesses that use high-quality homecare equipment or provide critical patient services.”

The article also quoted Tyler Wilson, president of the American Association for Homecare, saying, “This is not the solution to Medicare’s reform, and it is certainly not the answer for patients and seniors.”
To read the full article visit:

Tuesday, April 7, 2009

Pittsburgh Post-Gazette Reports on Competitive Bidding

If the competitive bidding program goes into effect, "nine out of 10 people in [the DME] business are going to be forced out of business" because they won't be one of Medicare's approved vendors is how John Shirvinsky, executive director for the Pennsylvania Association of Medical Suppliers explained the programs affects to the Pittsburgh Post-Gazette. The Post-Gazette published an article on April 7 discussing the flaws of the competitive bidding program for durable medical equipment, stating the new program will reduce competition and limit access to needed wheelchairs, oxygen tanks and other vital equipment.

The article also quotes Lucy Spruill, director of public policy and community relations for United Cerebral Palsy of Pittsburgh, who believes the program will greatly reduce the number of suppliers for power wheelchairs. She states that currently patients can sit on a waiting list to receive their wheelchair for three to six months. If you reduce the number of providers, the wait time could increase for Medicare beneficiaries. “If you don't have a backup chair -- and insurance won't pay for that -- you can be bedridden for that period of time."

To read the full article, “Suppliers Denounce Medicare bid plan,” visit