Home Respiratory Leaders Submit Testimony to E&C Health Subcommittee for Hearing on COVID-19 Long Haul Impacts

CQRC stresses need for long-term sector stability to ensure continued access to those requiring respiratory care for both acute and chronic needs

WASHINGTON, DC – The Council for Quality Respiratory Care – a coalition of the nation’s leading home respiratory therapy providers and manufacturing companies – submitted testimony to the House Energy and Commerce Subcommittee on Health this week as part of its hearing, ”The Long Haul: Forging a Path through the Lingering Effects of COVID-19.” Highlighting the critical role home respiratory care suppliers have played amid the ongoing public health emergency (PHE), the statement urged lawmakers to support policies that will ensure long-term reimbursement stability for the home respiratory care sector.

”During the pandemic, CQRC members have been on the frontlines of the battle against COVID-19. They have experienced an increase in acute patients and fluctuations in the number of chronic patients, leading to shortages in equipment and supplies, and rising costs,” the written testimony stated . ”As the pandemic moves into its second year, a significant percentage of patients continue to experience respiratory conditions that require their ongoing reliance on home respiratory therapies.”

The confluence of the COVID-19 crisis with disruptive Medicare policies threaten to undermine patients’ access to critical respiratory care, according to the CQRC.

”Despite the challenges imposed by COVID-19, including fluctuating demand and historic supply shortages, the underlying driver of instability in our sector continues to be flawed Medicare reimbursement, documentation, and audit policies,” said Crispin Teufel, CQRC Chairman. “We applaud Congress and the Centers for Medicare & Medicaid Services (CMS) for acting quickly to implement policies that provided temporary relief during the initial phases of this crisis. While we continue to navigate the care needs of treating patients safely during the COVID-19 crisis, more must be done to support our frontline suppliers and the patients we serve, especially those whose battle with COVID-19 will continue indefinitely.”

To ensure long-term stability for the sector, the statement urges lawmakers and regulators to pursue a number of relief measures, including:

• Streamline documentation requirements to support patients with acute respiratory conditions.
  Given the growing number of patients who require home oxygen therapy for acute conditions like COVID-19, the statement calls on policymakers to extend certain flexibilities that allow these patients to continue receiving respiratory care in the home setting.
• Stabilize the reimbursement rates for home respiratory therapies.
  Current competitive bidding rates in rural regions continue to be dramatically lower than the actual cost of providing care to beneficiaries in these areas. As COVID-19 began spreading rapidly in rural regions, Congress provided relief by increasing reimbursement rates in these areas – a change that CMS embraced in the CY 2021 DMEPOS Fee Schedule proposed rule. The CQRC testimony urges CMS to finalize this rule in order to maintain access to home respiratory treatments in rural America.
• Prevent Medicare from ”second-guessing” physician prescriptions.
  Prior to the pandemic, home respiratory therapy suppliers battled an overwhelming number of audits that resulted in claim denials. The majority of these denials were the result of ”insufficient” wording in physician medical records, undermining beneficiary coverage for critical home respiratory care. To remove this patient access barrier, the CQRC calls on Medicare to eliminate the requirement for contractors to review individual patients’ medical records for home respiratory therapies or establish prior authorization processes for home respiratory therapies.

”The CQRC remains committed to working with federal, state, and local officials to ensure COVID-19 patients and those with other chronic respiratory diseases have access to important  home respiratory therapies,” added Teufel. ”We look forward to working with the Subcommittee to make sure Americans in need of home oxygen, sleep, or non-invasive ventilation therapies, are able to access these life-sustaining treatment options without delay.”

To read the full statement, click here.

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About the Council for Quality Respiratory Care
The CQRC is a coalition of the nation’s seven leading home oxygen therapy provider and manufacturing companies. To learn more, visit cqrc.org and follow CQRC on Twitter at @TheCQRC.