Home medical equipment

This article discusses the definitions and types of home medical equipment (HME), also known as durable medical equipment (DME), prosthetics and orthotics (DMEPOS).

Additional recommended knowledge

How to quickly check pipettes?

Essential Laboratory Skills Guide

Daily Sensitivity Test

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 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.[1]

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 ioniser
• Air purifier
• Artificial limb
• Breast protheses
• Cannula
• Commodes
• Crutch
• Diabetic shoes
• Dynamic splint
• Enteral nutrition
• Infusion pump
• Nasal cannula
• Nebulizer
• Orthosis
• Oxygen concentrator
• Patient lift
• Positive airway pressure (CPAP)
• Prosthesis
• Respiratory Assist Devices
• Seat Lift
• Walkers
• Wheelchair

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[2] and Invacare[3], 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 reqquired to comply with Health Insurance Portability and Accountability Act (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 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.