Proposed oxygen changes: Overall, they're positive, providers say

YARMOUTH, Maine – Providers support proposed changes to the oxygen benefit that they say will ease paperwork burdens and expand access to therapy, but they’d like to see more details. 

CMS in July issued a proposed national coverage determination for home oxygen therapy that, among other things, removes the CMN requirement and expands access for acute conditions. 

“This would open it up for physicians being physicians and prescribing what they see as a needed benefit – that’s a good thing,” said David Hosemann, owner of Hometown Medical in Vicksburg, Miss. “What concerns me is, any time you open up a policy and change it, is the interpretation downstream, particularly by the policymakers, CMS and the folks seeing the claims.” 

Providers, by and large, support doing away with the CMN, which they say was duplicative of the medical record. 

“I’m a fan of eliminating the CMN and it is in line with other CMNs they’ve eliminated,” said Missy Cross, general manager of ProMedica in Sandusky, Ohio. “My feeling with the CMN was it was a reiteration of what was in the medical record, so it was an added step.” 

CMNs also create a lot of back and forth between the provider and the physician to get all the fields filled out correctly, so eliminating that dance can only improve relationships with referral sources – and boost cash flow, say providers.  

“We have all this to do and then we’re waiting on the physician to sign the CMN and their offices are overwhelmed with paperwork,” said Brian Wilson, COO of Commonwealth Home Health Care in Danville, Va. “It can take weeks or months to get the paperwork and you are not able to bill. I think this will improve that dramatically.” 

However, audit-weary providers would also like to see further guidance on what the medical records need to include for claims to pass muster. 

“It’s hard enough to get physicians to fill out the CMN correctly,” says Regina Gillispie, president and owner of Best Home Medical in Barboursville, W.Va.  “But how do they do notes and follow-up notes? They may mention oxygen, but may not put the exact wording, and where does that leave us? It’s subjective until they give more guidance, because the audits have been so crazy.” 

Wilson acknowledges that the subjectiveness of medical records can be scary, but he feels “relatively comfortable”” that the documentation he collects can stand up in audit. 

“We’ve been through several audits and it has been fine,” said Wilson. “Most of the providers I talk to all feel this is a positive.”