Tag: Council for Quality Respiratory Care (CQRC)

WASHINGTON – Fourteen members of the U.S. House of Representatives have sent a letter to CMS urging the agency to clarify Medicare documentation requirements for supplemental oxygen and adopt a standardized template for documenting patient need, according to the Council for Quality Respiratory Care.  “We 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...

WASHINGTON – With a “massive” number of patients starting on home respiratory therapy during the COVID-19 pandemic, the Council for Quality Respiratory Care is renewing its call for a transition period to ensure those patients don’t lose access when the public health emergency ends on May 11, says the Council for Quality Respiratory Care.  While providers are ready to move past the pandemic, much of that readiness depends on any guidance CMS provides, especially for...

WASHINGTON – President Joe Biden has announced that the public health emergency will end on May 11, 2023.  Under the last declaration in January, the PHE was set to end on April 11.  “The advance notice goes beyond HHS Secretary Xavier Becerra’s previous guidance to health care stakeholders that the agency would provide at least 60 days advance notice before ending the PHE,” AAHomecare noted in a bulletin.  Knowing when the PHE will end gives industry...

WASHINGTON – The Council for Quality Respiratory Care, is calling on the federal government to implement policies to ensure patients do not experience barriers to maintaining access to home oxygen, sleep and non-invasive ventilator therapy due to new paperwork requirements that are set to take effect when the COVID-19 public health emergency ends on May 11.  “The public health emergency declaration went a long way towards ensuring the more than 1.5 million patients who rely on...

WASHINGTON – CMS plans to primarily focus MAC, RAC and SMRC medical reviews on claims with dates of service outside of the public health emergency, the agency stated in a recent clarification.  CMS stated:  “During the PHE, flexibilities were applied across claim types. For certain DME items, this included the non-enforcement of clinical indications for coverage. Since clinical indications for coverage were not enforced for certain DME items provided during the PHE, once...

WASHINGTON – The Council for Quality Respiratory Care used a recent Request for Information from CMS to push for clear, objective clinical data elements for oxygen that are consistent with existing CMS-developed “templates” to ensure access to care for home respiratory patients.  In its comments on “Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs, the CQRC also urges CMS to issue clear guidelines about what to expect after the COVID-19 public...

WASHINGTON – High-risk providers represent a small portion of all providers who billed for a telehealth service, but strong, targeted oversight of these services is still important, according to a new report from the Office of Inspector General.  The OIG identified 1,714 providers out of about 742,000 whose billing for telehealth services during the first year of the pandemic posed a high risk to Medicare, representing a total of $127.7 million in Medicare fee-for-service payments for...

WASHINGTON – With local coverage determinations for home oxygen therapy anticipated in October, Crispin Teufel, chair of the Council for Quality Respiratory Care, hopes the industry will get more clarity on a post-CMN environment.   The CMS requirement for CMNs is set to expire Jan. 1, 2023, and the industry has been pushing for a simple template with clear and objective clinical elements, says Teufel, who is also the CEO of Lincare.  “There’s not a lot of time,...

WASHINGTON – CMS has opened the National Coverage Determination for seat elevation systems used with power wheelchairs, but the agency is not reconsidering coverage for power standing systems at this time.  CMS said in May it would commit to re-opening the NCD, nearly two years after the ITEM Coalition submitted a formal request to reconsider the NCD for mobility assistive equipment to include coverage for these systems.   “Now is the time for Medicare – the largest...

WASHINGTON – The Council for Quality Respiratory Care applauded the 22 bipartisan House lawmakers for urging the CMS to protect patients’ access to home oxygen. In a letter, spearheaded by Reps. Terri Sewell, D.-Ala., and Larry Bucshon, R.-Ind., to Department of Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure, they wrote in support of reforms to the home oxygen therapy benefit, and asked the agency to ensure that Medicare contractor documentation...