Sec. 301 Use of electronic templates to document medical necessity and restoring clinical inference for oxygen and oxygen related equipment, supplies, and services
“(G) Adoption of electronic templates to document medical necessity
“(i) In general—For any oxygen and oxygen related equipment, supplies or service, including liquid oxygen, furnished on or after January 1, 2025, the Secretary shall adopt a template in an electronic format that meets the requirements of clause (ii) to be completed by the prescribing practitioner (as defined by the Secretary) that shall constitute the complete request for information to determine whether payment for such service, equipment, or supplies is covered by this title and is reasonable and necessary for the diagnosis or treatment of illness or injury (under section 1862(a)(1)(A)).
“(ii) Template requirements—The template shall require the prescribing practitioner to provide each of the following:
“(I) Documentation that the beneficiary was seen by a prescribing practitioner within the appropriate timeframes for certification of the need for the services, equipment, or supplies.
“(II) Documentation of the qualifying blood gas or saturation test results.
“(III) Documentation indicating that the beneficiary needs or is using the appropriate equipment, supplies, and services.
“(IV) Any other documentation determined appropriate by the Secretary, except the Secretary shall not require the prescribing practitioner to provide medical record notes regarding the beneficiary.
“(iii) Contractor adjudication—The Secretary shall require Medicare administrative contractors to adjudicate claims for payment for oxygen and oxygen related equipment, supplies, and services using electronic transactions.
“(H) Restoration of clinical inference and judgment—For claims submitted on or after the date of enactment of this subparagraph with respect to the conduct of payment audits of suppliers of oxygen and oxygen related equipment, supplies, and services under this part the Secretary shall use clinical inference and clinical judgment in the evaluation of templates, medical records, and orders when conducting such audits in the same manner as the Secretary interpreted and applied such clinical judgment to claim reviews before 2009 pursuant to the Secretary’s instruction to contractors.”