11/29/2018

Keep Ventilators Out of Bidding Program!

Comments Due December 17

On Nov. 1, CMS put out a request for comments to include certain ventilator classes (HCPCS codes E0465, E0466, and E0467) in the next round of the competitive bidding program, as well as adding several knee and back brace HCPCS codes to the CBP.

The downside of adding ventilators, which are highly specialized and service-intensive products, is clear to respiratory service providers who have first-hand knowledge of ventilators’ critical importance to patients with serious health issues.

“Ventilators are literally life support systems for the individuals who use them,” said Tom Vorhees, CEO of PromptCare, a respiratory and infusion therapy provider serving both adult and pediatric ventilator patients throughout the Mid-Atlantic and Northeast regions. “Including these products in the bidding program is guaranteed to reduce the number of companies with the experience and clinical expertise needed to serve this vulnerable patient cohort.  If CMS' decision to include ventilators in competitive bidding results in a lack of access to these critically important products, the impacts on Medicare and Medicaid beneficiaries and their caregivers will be devastating.”

“After years of decimating access to home medical equipment and supplies due to the unsustainable competitive bid program, CMS now wants to attack the technologies used by its most vulnerable beneficiaries,” adds Al Neumann, RCP, RRT, NPS, CPFT, vice president of Minnesota-based Corner Home Medical.  “Respiratory companies need to make significant investments to train caregivers, stock backup equipment and supplies, and provide 24/7 therapists on call to make sure patients can avoid hospital visits and other clinical interventions.  I’d like CMS to tell us what part of those services they would like us to cut back on when bidding drives down reimbursement rates even further.”

“Awarding contracts for life support equipment to lowest bidders is going to have grave consequences for patients, families, and other medical professionals who support this community,” concludes Neumann. “It’s bad policy, and it’s going to cause a lot of suffering for people who depend on ventilators”  

Make Sure CMS Gets the Message!

We need to send a clear and compelling message that adding ventilators to the bidding program is clinically unsound and will severely impact vulnerable patients.  Please share your concerns with CMS by Monday, December 17 via DMEPOS@cms.hhs.gov.

We have developed a brief messaging document to help you formulate your comments and make the case for keeping ventilators out of the bidding program.  It is important to personalize your comments by explaining the types of ventilator patients you serve and the services you provide them, and how they will be impacted if CMS includes ventilators in the competitive bidding program.

Our messaging document also provides language asking CMS to provide more specific coverage criteria for ventilators instead of adding these products to the bidding program.

Please share this message with any patients, clinicians, hospitals, caregivers, or respiratory patient groups and encourage them to share comments with CMS on the need to maintain patient access to ventilators by keeping them out of the bidding program.  Just like the HME community, these individuals should be “engaged and enraged” to make sure these critically important products and services remain fully available.

AAHomecare has consistently advocated for keeping ventilators out of the bidding program, including recent comments to MedPAC (see page 4) on the issue.  We are also working with respiratory therapy clinician groups, as well as patient advocacy groups with constituencies who depend on these products, to echo our concerns in their comments to CMS. 

AAHomecare will also share our comments with you when they are completed.