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Stakeholders urge Becerra to protect access

Stakeholders urge Becerra to protect access

WASHINGTON – Industry stakeholders have joined major respiratory associations in asking the Department of Health and Human Services to protect access to respiratory products for patients who qualified for care under relaxed guidelines during the COVID-19 public health emergency. 

In a letter to HHS Secretary Xavier Becerra, the group, which includes AAHomecare, VGM, the American Association for Respiratory Care, the American Lung Association, the American Thoracic Society, the Council for Quality Respiratory Care and the Pulmonary Fibrosis Foundation, writes they believe more than 1 million Medicare beneficiaries were prescribed respiratory products during the PHE. 

“It is not logistically possible given the current stresses in the health care system to expect all of these beneficiaries to visit their physicians and to be tested again by the expected May 11 end-date for the PHE,” they state in the letter. 

The group is asking HHS to:  

Grandfather home oxygen, sleep therapy and NIV non-invasive patients in terms of the qualification requirements that were in place during the pandemic.  

Confirm CMS’s stipulation that any patient set up during the PHE who ended service during the PHE or within one year of the end of the PHE will not have their claims subject to a medical necessity audit. 

Eliminate the medical record review and urge CMS to instead accept the clinician prescription/standard written order as the required documentation for establishing medical necessity, as it does for other prescription medications.


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