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Dear Colleague letter seeks oxygen template

Dear Colleague letter seeks oxygen template

WASHINGTON – Reps. Terri Sewell, D-Ala., and Larry Bucshon, R-Ind., have released a Dear Colleague letter asking CMS to adopt a clear, easy to understand template letter for home oxygen equipment and supplies that asks for specific, standardized information to ensure patient needs are met. 

CMS in July 2021 issued a proposed national coverage determination for home oxygen therapy that removes the CMN requirement, but industry stakeholders believe the agency needs to determine what documents suppliers must provide to receive Medicare payment. The template letter prevents confusion and denials of these necessary, critical oxygen services, they say.

“CMS data show that the majority of denials of claims for beneficiaries receiving home oxygen therapy result from a clinician’s medical record not meeting the contractors’ standards, rather than the beneficiary’s condition not warranting the oxygen equipment and supplies,” states the letter. “CMS has created a template that would tell prescribing clinicians what information they need to provide to support beneficiaries’ accessing this important home therapy. This template could replace the use of medical record notes to streamline the audit review process.” 

Stakeholders are asking providers to reach out and ask their members of Congress to sign the letter by Aug. 3.

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