Reps. Terry Sewell (D-AL) and Adrian Smith (R-NE) are leading an effort to help maintain strong access to home oxygen for individuals with respiratory challenges.
These legislators are asking their peers in the House to join a sign-on letter to CMS Administrator Chiquita Brooks-LaSure requesting that Medicare 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 during the recently ended COVID-19 public health emergency (PHE).
The proposed sign-on 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 health care system, requiring patients who utilize these services to repeat their therapy qualification process. This would especially place an undue burden on rural patients," AAHomecare (AAHC) said in a press release.
According to AAHomecare, the sign-on letter also raises concerns on the policy of medical record review outlined in the oxygen national coverage determination and related local coverage determinations that are set to take effect. The letter asks CMS to protect patient access by instructing contractors to use CMS’ widely accepted oxygen clinical data element templates, along with the standard written order, in lieu of medical record notes, to determine medical necessity.
"Please send a message to your Representative in the House asking them to join the sign-on letter," AAHomecare said. "You can use our Voter Voice advocacy system to send a pre-drafted note to your Representative. You can also modify the letter to include your own perspectives and experiences supporting oxygen patients."
The sign-on letter is set to close on July 27.
"Please take actio—and encourage your peers and friends to send a message, too—to help protect patient access to critically important home respiratory therapies and support the efforts of Reps. Sewell and Smith to raise the visibility and urgency of this issue," AAHC said.