Home Medical Equipment
Home medical equipment is a category of devices used for patients whose care is being managed from a home or other private facility managed by a nonprofessional caregiver or family member. It is often referred to as "durable" medical equipment (DME) as it is intended to withstand repeated use by non-professionals or the patient, and is appropriate for use in the home.
Medical supplies of an expendable nature, such as bandages, rubber gloves and irrigating kits are not considered by Medicare to be DME.
Within the US medical and insurance industries, the following acronyms are used to describe home medical equipment:
- DME: Durable Medical Equipment
- HME: Home Medical Equipment
- DMEPOS: Durable Medical Equipment, Prosthetics, Orthotics and Supplies
Types of home medical equipment
- Air ionizer
- Air purifier
- Artificial limb
- Breast prostheses
- Diabetic shoes
- Dynamic splint
- Enteral nutrition
- Infusion pump
- Nasal cannula
- Oxygen concentrator
- Patient lift
- Positive airway pressure (CPAP)
- Respiratory Assist Devices
- Seat Lift
Obtaining and using home medical equipment
For most home medical equipment, a patient must have a doctor's prescription for the equipment needed this is not always true for minor HME such as walkers or canes.
The physician may then recommend a supplier for the home medical equipment, or the patient will have to research this on their own. HME / DMEPOS suppliers are located throughout the country for suppliers of oxygen and other critical medical equipment, Medicare rules require the supplier to only serve patients within a fixed distance, to ensure their ability to deliver supplies and maintain equipment in a timely fashion. For most areas of the US this results in a great number of local HME / DMEPOS suppliers available to the patient in their immediate area.
There is no established typical size for HME / DMEPOS suppliers. Supply companies include very large organizations such as WalGreens and Invacare, to smaller local companies operated by sole proprietors or families. A new evolution in the Home Medical Equipment arena is the advent of internet retailers such as US Medical Aid who are operating with extremely low margins and cutting the ultimate cost for end consumers. In all cases, however, strict rules and laws governing HME / DMEPOS suppliers apply.
Once a patient or caregiver selects an appropriate HME / DMEPOS supplier, he/she presents the supplier with the prescription and patient's insurance information. HME / DMEPOS suppliers maintain an inventory of products and equipment, so fulfillment of the prescription is rapid, much like a Pharmacy.
The HME / DMEPOS supplier is obligated to perform certain functions when providing home medical equipment. These include:
- Proper delivery and setup of the equipment
- Ensuring the home environment is suitable and safe for proper usage of the equipment
- Training the patient, family and caregivers on the proper usage and maintenance of the equipment
- Providing 24-hour contact information in the event of equipment malfunction or other emergency
- Informing the patient and/or caregiver of their rights and responsibilities
- Providing periodic maintenance services (e.g., refilling oxygen, servicing equipment, etc.)
- Notifying the patient or caregiver of any changes in insurance
All HME / DMEPOS suppliers are required to comply with Health Insurance Portability and Accountability Act (HIPAA) to protect patients' confidentiality and records.
Home medical equipment is typically covered by patient's healthcare insurance, including Medicare (Part B). In order to properly code home medical equipment for billing, the Healthcare Common Procedure Coding System HCPCS is utilized.
As of 2007, under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, providers of HME/DMEPOS will be required to become third-party accredited to standards regulated by the Centers for Medicare and Medicaid Services (CMS) in order to continue eligibility under Medicare Part B. This effort aims to standardize and improve the quality of service to patients provided by home medical equipment suppliers.
Durable Medical Equipment Defined
Durable medical equipment is a term of art used to describe certain Medicare benefits, that is, whether Medicare may pay for the item. The item is defined by Title XVIII the Social Security Act:
The term “durable medical equipment” includes iron lungs, oxygen tents, hospital beds, and wheelchairs (which may include a power-operated vehicle that may be appropriately used as a wheelchair, but only where the use of such a vehicle is determined to be necessary on the basis of the individual's medical and physical condition and the vehicle meets such safety requirements as the Secretary may prescribe) used in the patient's home (including an institution used as his home other than an institution that meets the requirements of subsection (e)(1) of this section or section 1819(a)(1)), whether furnished on a rental basis or purchased, and includes blood-testing strips and blood glucose monitors for individuals with diabetes without regard to whether the individual has Type I or Type II diabetes or to the individual's use of insulin (as determined under standards established by the Secretary in consultation with the appropriate organizations) except that such term does not include such equipment furnished by a supplier who has used, for the demonstration and use of specific equipment, an individual who has not met such minimum training standards as the Secretary may establish with respect to the demonstration and use of such specific equipment. With respect to a seat-lift chair, such term includes only the seat-lift mechanism and does not include the chair.