CQRC: Medicare’s Oxygen E-Template Offers Available Solutions to Combat Fraud & Abuse
As E&C lawmakers examine policies to detect, prevent, and fight fraud impacting Medicare beneficiaries, CQRC calls for immediate adoption of the oxygen template for e-prescribing.
WASHINGTON – The Council for Quality Respiratory Care (CQRC) commends the House Energy & Commerce Subcommittee on Oversight and Investigations, including E&C Chair Brett Guthrie (KY-02) and Subcommittee Chair John Joyce, M.D. (PA-13), for this week’s hearing, Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid, to examine solutions for addressing systematic fraud impacting the Medicare and Medicaid programs. CQRC urges lawmakers on the subcommittee to support the adoption of an electronic supplemental oxygen template by Medicare to strengthen the program’s supplemental oxygen benefit.
To improve access to supplemental oxygen care while strengthening documentation processes and reducing unnecessary audits for supplemental oxygen claims, the CQRC has been working collaboratively with the Centers for Medicare & Medicaid Services (CMS) for many years to advocate for the adoption of an electronic template to provide clarity and accuracy in the oxygen prescription and ordering process. The Medicare program has historically relied on physician medical record notes as the primary tool for Medicare contractors to establish medical need for patients, which has resulted in improper denials and risks access to supplemental oxygen for beneficiaries.
The CQRC strongly advocates for the adoption of an electronic template with standardized clinical data elements in place of contractors’ reliance on the patient medical record, which can be subjective and inconsistent. By adopting a standard e-template, Medicare can more effectively reduce fraudulent or abusive claims while also improving transparency in what information prescribers need to use when ordering supplemental oxygen for their patients.
“We support the committee’s goal of eliminating fraudulent activities that harm Medicare and Medicaid beneficiaries and urge them to consider existing documentation improvements that could quickly be adopted, including the supplemental oxygen template,” said Robin Menchen, Chair of the CQRC. “Leaders in the Administration, and many lawmakers in Congress, have indicated support for the adoption of a standardized supplemental oxygen template to document medical necessity more effectively for patients who depend on supplemental oxygen. It is time for full adoption of the oxygen template to effectively reduce fraud while protecting the delivery of the right oxygen care to the right patients.”
The CQRC urges Congress to pass the bipartisan Supplemental Oxygen Access Reform (SOAR) Act (S. 1406/H.R. 2902), a comprehensive reform bill that includes a provision to mandate the use of the oxygen template to prevent unwarranted claims denials.
####
The Council for Quality Respiratory Care (CQRC) is a coalition of the nation’s leading home oxygen therapy providers and manufacturing companies providing in-home patient services and respiratory equipment including liquid oxygen, oxygen concentrators, and sleep therapy devices to Medicare beneficiaries who rely upon home oxygen therapy to maintain their independence and enhance their quality of life. Learn more at cqrc.org.
Media Contact:
Ellen Almond
202-271-0234