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CQRC Commends the Congress for Assisting with Rural Home Medical Equipment and Services in COVID-19 Emergency Response Bill

New policy changes will help prevent potential disruptions in supply and workforce, but more must be done to further ensure continued access to home respiratory care.

Washington, DC, March 27, 2020 --( The Council for Quality Respiratory Care (CQRC) – a coalition of the nation's leading home oxygen therapy provider and manufacturing companies – commends the Congress for including policy measures in the third coronavirus emergency relief package to protect access to care for home respiratory patients during the ongoing national emergency.

The bill, The Coronavirus Aid, Relief, and Economic Security Act (S. 3548), was crafted through bipartisan negotiations and includes a number of provisions to help address the crisis caused by COVID-19. The bill specifically includes an encouraging provision for home respiratory care providers that allows the Centers for Medicare & Medicaid Services (CMS) to extend the rural blended rate through the end of the emergency, and to create and implement a nonrural noncompetitive bidding area (nonCBA) rate through the same period.

“CQRC appreciates that the Congress has recognized the critical role that home respiratory care suppliers can play in the country’s response to the COVID-19 outbreak,” said CQRC Chairman Dan Starck. “The provisions passed in the CARES Act are an important step to help provide stability so that suppliers can focus on patient care.”

The inclusion of this important provision follows a letter sent by CQRC to CMS Administrator Seema Verma outlining how the home respiratory sector is prepared to help patients address the COVID-19 emergency and urging the agency to eliminate some of the regulatory restrictions that create barriers to care. Because the in-home respiratory care sector is anticipating the need for more resources to meet the patient care demands of the national emergency, this provision will help suppliers avoid potential disruptions in supply and workforce.

Advice published in the New England Journal of Medicine from physicians trying to manage the COVID-19 crisis in Italy urges Americans to move patients to the home. “Home care and mobile clinics avoid unnecessary movements and release pressure from hospitals,” the physicians wrote. “Early oxygen therapy, pulse oximeters, and nutrition can be delivered to the homes of mildly ill and convalescent patients, setting up a broad surveillance system with adequate isolation and leveraging innovative telemedicine instruments. This approach would limit hospitalization to a focused target of disease severity, thereby decreasing contagion, protecting patients and health care workers, and minimizing consumption of protective equipment.”

Being able to implement this advice will require home respiratory providers to increase their capacity – adding to their workforce and purchasing new equipment – to serve the beneficiaries who need these services at home. Yet, CMS is moving forward on implementing the next round of the competitive bidding program that seeks to restrict capacity and reduce the number of suppliers in specific areas.

“Having a new [competitive bidding program] coupled with COVID-19 exposure and increasing cases could cause havoc in rural areas if more patients require home respiratory therapies to treat the virus under quarantine or near quarantine conditions,” CQRC wrote to Administrator Verma. “Equipping our workforce to safely engage with these patients and their families will also take more resources than anyone could have anticipated during the competitive bidding process.”

In addition to the provisions included in the CARES Act, CQRC is urging the Congress to advance the following in any future coronavirus relief measures:

· Make sure home respiratory therapy personnel who work directly with patients in their homes are among the health care workers who are prioritized to receive personal protective equipment (PPE). This would ensure both patient and provider safety, while minimizing the risk of exposure to the novel coronavirus.
· Pay for all patients with acute medical conditions that require oxygen, PAP, or ventilators. This will ensure that home respiratory care providers can respond to the requests of States, local public health officials, and hospitals who are trying to triage lower acuity patients home and save hospital beds for the sickest patients.
· Temporarily suspend all home respiratory therapy audits and eliminate medical record review. CMS should also relax other paperwork requirements (such as the certificate of medical need or patient signatures). Pausing these requirements will free up doctors and hospitals from chasing paperwork and allow patients to avoid touching tablets, pens, or paper that could spread the virus.
· Support home respiratory care providers as they work to expand their ability to care for respiratory patients at home by pausing the implementation of the competitive bidding program (CBP) through at least December 31, 2021 and extending the blended rate in rural areas and newly created nonCBA, nonrural rates during the same time period.

Ensuring the quick passage of these provisions is crucial to helping patients - both those with chronic conditions and those presenting acute respiratory symptoms as a result of exposure to COVID-19 - access the home respiratory therapy that their doctors prescribe, which will ultimately save lives.

About the Council for Quality Respiratory Care
The CQRC is a coalition of the nation's seven leading home oxygen therapy provider and manufacturing companies. To learn more, visit and follow CQRC on Twitter at @TheCQRC.
Contact Information
Ellen Almond

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