CQRC calls for safeguards to home respiratory access

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 supplemental oxygen, non-invasive ventilation, and other forms of home respiratory care can access the critical, life-preserving care they need,” said Crispin Teufel, CQRC chair and CEO of Lincare. “While the end of PHE was inevitable—and the advance announcement is welcome—home respiratory patients and providers need more clarity and support to prevent potentially dangerous delays in care.”  

The CQRC is calling for a transition period with clear expectations that outline what documentation suppliers must obtain from physicians so that patients who have been prescribed home respiratory care can continue receiving these treatments.  

Specifically, the organization joins others in the home respiratory community in urging Medicare to avoid requiring patients who received home respiratory therapies during the PHE to schedule new doctor’s appointments and get a second set of tests just to create paperwork that the government suspended during the PHE.   

“If all patients need to be requalified, it will cause serious patient access issues and create enormous demand for already-overburdened physicians,” said Teufel. “There are simply not enough physicians to re-evaluate and re-test the more than 1 million patients who rely upon these therapies during the next 100 days.” 

In addition, when the PHE ends, CMS plans to implement a medical record-only review that the CQRC estimates will result in between 75% and 90% of claims being denied because they may not find the medical record does not support the physician’s decision to prescribe the therapy.   

“During the pandemic, we have learned the critical role that home respiratory therapy plays in keeping individuals out of the hospital, at home and in their communities,” said Teufel. “We welcome the opportunity to work closely with the administration and Congress to make sure that the transition from the pandemic to the new normal does not cause those who rely upon home respiratory therapies to lose access to the treatment options prescribed for them. It is important that they can continue to actively engage with their families, friends, and neighbors.”