AARC Pursues Denial Rulings Through HCFA

January 26, 1999
Problems with reimbursement for services in the northwestern states continue to plague respiratory therapy. AARC has recently contacted both the local intermediary and the HCFA Regional Administrator to harshly voice concerns about their handling of recent policy implementations.

Last September, AARC wrote to the Alaska fiscal intermediary because they had implemented a policy of denying routine respiratory therapy services when provided by respiratory therapists. A December response from the intermediary noted that this policy was not just a local policy, but apparently was a regional HCFA directive affecting Washington, Idaho, and Oregon as well.

Last week, AARC fired off a response to that intermediary demanding to know about the comment period and, more importantly, the medical justifications and clinical evidence for their decisions.

Problems with reimbursement have been especially rampant in this area of the U.S. primarily due to the opinions and decisions of one individual. AARC's campaign to fight these decisions is extending to the entire HCFA region, as we have additionally written to Linda Ruiz, the regional administrator of HCFA for that area.

"It is disconcerting to have the welfare of respiratory patients and, indeed, the welfare of this profession, reside with one person," said Cheryl West, AARC Director of Government Affairs. "But the reality is that is what is happening. We will make an all-out effort to reverse these decisions."