New Louisiana ventilator protection law makes way for broader healthcare access

LAKE CHARLES, La. (KPLC) - Access to certain healthcare equipment has come into question even more since the onset of COVID-19, as equipment like ventilators have played a critical role in the battle against the virus.

Prior to the pandemic, ventilators were mostly being used by home healthcare patients.

The Louisiana State Senate voted unanimously to approve H.B. 594, legislation to prevent payers such as private pay insurance and managed care organizations from capping reimbursement for ventilators.

The Senate passage follows an 84-14 vote in the Louisiana House of Representatives, which upvoted the measure, requiring insurers, MCOs, and other payers to reimburse ventilators on a continuous monthly rental basis without capping payments at the device’s purchase price.

”It’s really about ensuring access to care for those users and those with the complex medical needs that benefit from ventilation therapy,” David Chandler, Senior Director of Payer Relations for the American Association for Homecare, said.

Louisiana Home Medical Equipment stakeholders and the American Association for Homecare advocated on behalf of the legislation to convince state legislators to remove proposed amendments that could have capped costs for non-invasive ventilators and restricted HME suppliers’ ability to provide important service and maintenance for specialized products.

”The legislation, it ultimately ensures that payers in the state of Louisiana do not cap reimbursement for ventilation treatment in the home,” Chandler said.

SUMMARY

House Bill 594 - a definition of The Protecting Home Oxygen & Medical Equipment Act, allows for increased reimbursement rates for durable medical equipment and oxygen equipment and supplies in areas of the country where reimbursement has been slashed up to 50%.

The legislation marks a landmark decision for home healthcare providers in Louisiana.

”Homecare being the most cost-effective option available to payers, it’s really in the best interest of everyone,” Chandler said.

Chandler said it’s a big move for the state, given a recent decline in home health care providers.

Chandler noted that Louisiana has seen a 37% decline in durable medical equipment (DME) providers since 2013, and out of the state’s 64 parishes, there are 29 parishes that don’t have a traditional DME supplier, and 47 parishes don’t have a ventilator provider.

”In the last decade, we’ve seen 44% reduction in supplier locations,” Chandler said. “When we talk about ventilation therapy - and if payments are capped during a period of medical need, then providers may be forced to discontinue care.”

READ: DECLINE OF MEDICAL EQUIPMENT PROVIDERS IN THE U.S OVER THE PAST 10 YEARS

With no clear end in sight in regards to COVID, Chandler said the legislation is also beneficial for those suffering from long-term complications.

”Legislation like this will ensure that there’s adequate reimbursement for providers to stay in business and expand their business and expand their product offerings for patients, especially those with complex medical needs.”

He said with the delta variant sweeping the Nation, the law makes way to provide more broad homecare options for those most vulnerable patients.

The law went into effect on August 1.

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