Home medical equipment
Encyclopedia
This article discusses the definitions and types of home medical equipment
(HME), also known as durable medical equipment
(DME), prosthetics and orthotics (DMEPOS).
(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:
The physician may 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.
There is no established typical size for HME / DMEPOS suppliers. Supply companies include very large organizations such as WalGreens, Lincare, and Apria 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 who are operating with extremely low margins and cutting the ultimate cost for end consumers, but often without the in-home setup and training. In all cases, however, strict rules and laws govern HME / DMEPOS suppliers that participate Medicare and Medicaid program. In addition to rules outlined the National Supplier Clearinghouse, of division of CMS (centers for Medicare and Medicaid), all Medicare DME suppliers must obtain and maintain accreditation by one of many approved accrediting bodies.
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:
All HME / DMEPOS suppliers are required to comply with Health Insurance Portability and Accountability Act
(HIPAA) to protect patients' confidentiality and records.
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.
Medical equipment
Medical equipment is designed to aid in the diagnosis, monitoring or treatment of medical conditions.-Types:There are several basic types:* Diagnostic equipment includes medical imaging machines, used to aid in diagnosis...
(HME), also known as durable medical equipment
Durable medical equipment
Durable medical equipment is a term of art used to describe any medical equipment used in the home to aid in a better quality of living. It is a benefit included in most insurances. In some cases certain Medicare benefits, that is, whether Medicare may pay for the item...
(DME), prosthetics and orthotics (DMEPOS).
HME / DMEPOS
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 equipmentDurable medical equipment
Durable medical equipment is a term of art used to describe any medical equipment used in the home to aid in a better quality of living. It is a benefit included in most insurances. In some cases certain Medicare benefits, that is, whether Medicare may pay for the item...
(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
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
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 ioniserAir ioniserAn air ioniser is a device that uses high voltage to ionise air molecules. Negative ions, or anions, are particles with one or more extra electrons, conferring a net negative charge to the particle. Cations are positive ions missing one or more electrons, resulting in a net positive charge...
- Air purifierAir purifierAn air purifier is a device which removes contaminants from the air. These devices are commonly marketed as being beneficial to allergy sufferers and asthmatics, and at reducing or eliminating second-hand tobacco smoke...
- Artificial limb
- Breast protheses
- CannulaCannulaA cannula or canula is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of data...
- Commodes
- CPAP Continuous Positive Airway Pressure
- CrutchCrutchCrutches are mobility aids used to counter a mobility impairment or an injury that limits walking ability.- Types :There are several different types of crutches:...
- Diabetic shoes
- Dynamic splint
- Enteral nutrition
- Elevating toilet seat
- Infusion pumpInfusion pumpAn infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used....
- Nasal cannulaNasal cannulaThe nasal cannula is a device used to deliver supplemental oxygen or airflow to a patient or person in need of respiratory help. This device consists of a plastic tube which fits behind the ears, and a set of two prongs which are placed in the nostrils. Oxygen flows from these prongs...
- NebulizerNebulizerIn medicine, a nebulizer is a device used to administer medication in the form of a mist inhaled into the lungs....
- Orthosis
- Oxygen concentratorOxygen concentratorAn oxygen concentrator is a device providing oxygen therapy to a patient at minimally to substantially higher concentrations than available in ambient air. They are used as a safer, less expensive, and more convenient alternative to tanks of compressed oxygen. Common models retail at around US$800...
- Patient lift
- Positive airway pressure (CPAP)
- ProsthesisProsthesisIn medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...
- Respiratory Assist devices
- Seat lift
- Walkers
- VacuPractor
- WheelchairWheelchairA wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...
Obtaining and using home medical equipment
For most home medical equipment to be reimbursed by insurance, a patient must have a doctor's prescription for the equipment needed. Some equipment, such as oxygen, is FDA regulated and must be prescribed by a physician before purchase whether insurance reimbursed or otherwise.The physician may 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.
There is no established typical size for HME / DMEPOS suppliers. Supply companies include very large organizations such as WalGreens, Lincare, and Apria 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 who are operating with extremely low margins and cutting the ultimate cost for end consumers, but often without the in-home setup and training. In all cases, however, strict rules and laws govern HME / DMEPOS suppliers that participate Medicare and Medicaid program. In addition to rules outlined the National Supplier Clearinghouse, of division of CMS (centers for Medicare and Medicaid), all Medicare DME suppliers must obtain and maintain accreditation by one of many approved accrediting bodies.
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
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...
.
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
- Informing the patient and/or caregiver of their rights and responsibilities
- Providing periodic maintenance services (e.g., refilling oxygen, servicing equipment, etc.)
All HME / DMEPOS suppliers are required to comply with Health Insurance Portability and Accountability Act
Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act of 1996 was enacted by the U.S. Congress and signed by President Bill Clinton in 1996. It was originally sponsored by Sen. Edward Kennedy and Sen. Nancy Kassebaum . Title I of HIPAA protects health insurance coverage for workers and their...
(HIPAA) to protect patients' confidentiality and records.
Insurance
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
Medicare Prescription Drug, Improvement, and Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...
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
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
(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.