In the hospital, you don't ask a patient for their insurancecard before you set up their ventilator. In home care, you can't even walk in the door without one. That gap is where this episode lives.

Mike and Rob sit down with Chrysalis Ashton — RRT, Master'sin respiratory care, Head of Respiratory Clinical Affairs and Industry Relations at Drive Medical, and the AARC's 2026 Specialty Practitioner of the Year for ambulatory and post-acute care — for a look at the ethics almost no one talks about: what happens to respiratory patients after they leave the hospital.

They dig into Medicare's new national coverage determination for non-invasive therapy in COPD, the word Chrysalis "loves and hates" — compliance — and the brutal dilemma it creates: when a patient clearly needs a device but isn't using it enough to satisfy their insurance, does the company take it back (the business call) or leave it in the homeunpaid (the clinical one)? Along the way: why insurance criteria can measure eligibility for payment more than actual health, how DMEs quietly absorb the cost of doing the right thing, and why so many family-owned providers don't survive it.

A rare, honest look at the intersection of clinical need, financial reality, and the patients stuck in the middle.

Join the conversation. Let's get ethical.