The American Association for Homecare (AAHomecare) is urging stakeholders to support a U.S. House sign-on letter protecting access to home oxygen.
In a July 17 bulletin, AAHomecare said Rep. Terry Sewell (D-Ala.) and Rep. Adrian Smith (R-Neb.) are leading the way by asking their colleagues to sign a letter addressed to Centers of Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. The letter asks Medicare to “accept the standard written order as the only necessary documentation to establish medical necessity when auditing claims of patients who received home oxygen, sleep therapy, or non-invasive ventilation equipment during the recently ended COVID-19 Public Health Emergency (PHE).”
Potential Consequences to Patient Access
The letter, AAHomecare added, “describes the potential consequences of applying more stringent reauthorization requirements for these patients: Approximately one million beneficiaries began supplemental oxygen and respiratory therapies during the PHE and will continue to require these services. The reauthorization process would overload the already stressed healthcare system, requiring patients who utilize these services to repeat their therapy qualification process. This would especially place an undue burden on rural patients.”
The letter adds, “We therefore write to request that auditors accept the standard written order (SWO) as the only necessary documentation to establish medical necessity when auditing claims of patients who received home oxygen, sleep therapy, or non-invasive ventilation equipment.”
The authors of the letter expressed concern that the medical record review requirement described in the oxygen national coverage determination and local coverage determinations would take effect: “If CMS allows contractors to rely only upon physicians’ medical record notes, a vast majority of patient claims will be denied, creating access issues for beneficiaries. CMS already created the oxygen clinical data element templates which are more practical in assessing coverage needs. We therefore urge CMS to require contractors to use these templates, along with the standard written order in lieu of medical record notes when determining medical necessity.”
AAHomecare is encouraging advocates to ask their Representatives to sign onto the letter. Using the Association’s Voter Voice advocacy system will enable participants to send pre-written notes to their Reps, though the notes can also be modified to include personal experiences and perspectives.
The letter, AAHomecare added, is due to close on Thurs., July 27… making time of the essence.