Dear colleague letter seeks oxygen model



WASHINGTON — Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., posted a Dear Colleague letter ask CMS to adopt a clear, easy-to-understand model letter for home oxygen equipment and supplies that requests specific, standardized information to ensure patient needs are met and recipients receive their critical home oxygen equipment and supplies.

In July 2021, CMS released a National Coverage Determination Proposal for Home Oxygen Therapy which, among other things, removes the CMN requirement and expands access for acute conditions. However, CMS will need to determine what documentation providers need to provide to receive payment from Medicare to ensure beneficiaries receive their devices. The purpose of a sample letter is to avoid confusion and denials of these vital and essential oxygen services.

“CMS data shows that the majority of claim denials for beneficiaries receiving home oxygen therapy result from a clinician’s medical record not meeting contractor standards, rather than the beneficiary’s condition not warranting the oxygen equipment and supplies,” the letter reads. “CMS has created a template that would tell prescribing clinicians what information they need to provide to help recipients access this important therapy at home. This model could replace the use of notes from the medical record to streamline the audit review process. »

It is important that you reach out today to ask your member of Congress to sign this letter because this letter is circulating in Congress for only 10 days. Please contact us today!

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