HME Definition

Home Medical Equipment (HME) is a category of medical equipment and supplies supplied and maintained by HME providers and used by patients whose care is being managed in their own home or community, rather than an institution setting.  The equipment is prescribed by a physician and certain non-physician practitioners, primarily and customarily used to serve a medical purpose; not useful to a person in the absence of illness, disability, or injury; must withstand repeated use; and appropriate for use in the home and community.  Providers permitted to furnish HME and necessary related services must be in compliance with all applicable federal and state laws and regulations (including but not limited to HIPAA, state licensure, Medicare, Medicaid, and other third party requirements).  The services and support of HME providers are essential to reducing duration of hospitalizations and to enable both chronic and acute patients, elderly or disabled to be cared for in their homes.

Patients needing HME require the following:

1. Delivery
2. Patient or home assessment, or both, as appropriate, to verify the appropriateness and safety of the prescribed item
3. Set-up
4. Instruction on:

a. Use and operation with return demonstration
b. Maintenance
c. How to seek assistance in the case of operational failure
d. How to report changes in medical conditions

5. Assistance in verifying insurance coverage and billing the patient’s insurance
6. Collecting needed documentation from physicians, hospitals, nursing homes, home health agencies and other healthcare professionals to support the medical necessity and coordinate care for such items
7. 24/7 availability of assistance for after hour and holiday services, where apropriate, including natural disaster or national emergencies (i.e. tornadoes, hurricanes, floods, blizzards, etc…  which necessitate additional staff, time, equipment, and resources to help prepare, respond and recover from said events)
8. Acting as liaison between patient and clinician to assure appropriateness of service
9. Advocating on behalf of the patient where reimbursement was challenged by the insurance carriers

updated May 2017