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September 2021
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Market Edge
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News for All Segments | All brands
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Philips Respironics recall for certain CPAP, BiPAP, and ventilator devices
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Philips Respironics issued a recall notification for specific brands of their continuous positive airway pressure (CPAP) machines, bi‑level positive airway pressure (BiPAP) machines, and ventilators. Philips identified that this recall is expected to impact millions of users, including AmeriHealth members.
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AmeriHealth will cover a replacement for a recalled Philips device for our members when this is the most appropriate decision according to the treating medical provider. The provider should take into consideration the individual circumstances of the member, available treatment options, and resources. There is no member cost-share for replacement devices for members affected by the Philips recall.
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Replacement devices are available for members of AmeriHealth and AmeriHealth Administrators plans when these four requirements are met:
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Requirement 1
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| AmeriHealth New Jersey and AmeriHealth Pennsylvania plans |
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AmeriHealth Administrators plan |
| The device to be replaced was a Philips device subject to recall. To view a list of devices subject to recall, please visit the Philips recall website. |
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The device to be replaced was a Philips device subject to recall. To view a list of devices subject to recall, please visit the Philips recall website. |
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Requirement 2
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| AmeriHealth New Jersey and AmeriHealth Pennsylvania plans |
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AmeriHealth Administrators plan |
The device was secured within the last five (5) years.
If the device was secured more than five years ago, the Durable Medical Equipment (DME) supplier must contact AIM for a new precertification. |
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The device was secured within the last five (5) years. |
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Requirement 3
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| AmeriHealth New Jersey and AmeriHealth Pennsylvania plans |
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AmeriHealth Administrators plan |
| The member or medical provider registers the current device with the Philips recall website (online or by phone). The requester will receive a confirmation number from Philips, which should be shared with the DME supplier (see requirement 4 below.) |
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The member or medical provider registers the current device with the Philips recall website (online or by phone). The requester will receive a confirmation number from Philips, which should be shared with the DME supplier (see requirement 4 below.) |
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Requirement 4
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| AmeriHealth New Jersey and AmeriHealth Pennsylvania plans |
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AmeriHealth Administrators plan |
The DME supplier providing the replacement device must submit the AmeriHealth Philips Respironics Attestation form to affirm steps 1 – 3. The Philips confirmation number must be included in the Attestation.
Submit the completed attestation form via email to philipsrecall@amerihealth.com.*
*This email is to submit attestations only. For questions, please contact Customer Service. |
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The DME supplier providing the replacement device must submit the AmeriHealth Philips Respironics Attestation form to affirm steps 1 – 3. The Philips confirmation number must be included in the Attestation.
Submit the completed attestation form with the precertification request. |
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In addition, the DME supplier must:
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- Obtain a certificate of medical necessity and include in the member's file within 60 days of receipt of the new device.
- Report the service as a new purchase, by appending the NU modifier to the applicable device procedure code, to be reimbursed the full purchase allowance.
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To learn more about the recall, please visit the Philips recall website. Please contact our Customer Service team at 1-888-YOUR-AH1 (AmeriHealth New Jersey) or 1-800-275-2583 (AmeriHealth Pennsylvania) with any questions. Those with AmeriHealth Administrators plans should reach out to their account representative.
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