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Deadline EXTENDED: Reach out to Your Representative Today!

Published in Government Relations on July 28, 2022

Government Update

The deadline has been extended to August 3rd on the Dear Colleague letter authored by Rep. Terri Sewell (D-AL) and Rep. Larry Bucshon (R-IN) requesting CMS to adopt a clear, easy to understand template letter for home oxygen equipment and supplies that asks for the specific, standardized information to ensure patient needs are met and beneficiaries receive their critical home oxygen equipment and supplies.

Click here to view the Dear Colleague Letter.

John Gallagher, VP of Government Relations, VGM & Associates, says, “We know that less than 1% of oxygen claims are improperly paid due to failing to meet medical necessity.  We are finding that many providers are caught in the middle with the catch 22 of providing the oxygen equipment prescribed…yet are denied claims due to incomplete doctor notes.  The solution is to remove the ambiguity and implement clearly stated templates that establish medical necessity.”

The letter is only going to be circulating around Congress for 5 more days, reach out and ask your member of Congress to sign this letter today!

Click here to quickly and easily message your member of Congress asking them to support this letter.

As you may recall, CMS recently expanded coverage for home oxygen equipment and supplies. However, CMS will have to determine what documents suppliers must provide to receive Medicare payment to ensure beneficiaries receive their devices. The goal for a template letter is to prevent confusion and denials of these necessary, critical oxygen services.

CMS has indicated that physicians will be required to turn over their medical records instead of using a form that asks for the clear and specific information CMS needs to pay the claim. The concern by many is that this requirement will result in the vast majority of claims being denied because physician records are not written to meet contractor needs, but rather to care for patients. This approach puts the contractor in the position of determining what the patient needs. Instead, the physician and patient should be making these decisions together. 

Attached here is the Community Letter that VGM and many other DMEPOS industry leaders supported back in October of 2021.  

This letter provides an outstanding opportunity for each Provider to build a relationship and connectivity with their Congressional Members office.  Ask that your member of congress sign on to the letter, and then offer the opportunity to stop by your place of business to “meet n greet” your employees, and explain more in detail what this letter aims to achieve.  This of all ask should be an easy sell for most providers.

Please take action today!

TAGS

  1. billing & reimbursement
  2. oxygen
  3. vgm
  4. vgm government

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