Vent bill back in play

Tuesday, December 5, 2017

WASHINGTON – Three senators have introduced a bill that would, they say, establish a clear medical guideline for non-invasive ventilators, the VGM Group reports.

S. 2175, the “Beneficiary Respiratory Equipment Access and Transparency to Home Ventilator Care” or the BREATH Act of 2017, would also pave the way for providers to receive a possible increase in reimbursement for non-invasive vents, pending any decreases in utilization.

Sens. Bill Cassidy, R-La., Charles Grassley, R-Iowa, and Joe Manchin, D-W.Va., introduced the bill on Nov. 30.

Cassidy and Grassley also introduced a similar bill last year, in response to sweeping changes that CMS has made to non-invasive vents, including reducing the number of codes for the product category from five to two, and reducing reimbursement by about 33%.

A companion bill in the House of Representatives will likely be introduced soon, with Rep. Larry Bucshon, R-Ind., leading those efforts, according to VGM.

In the past, stakeholders have also supported efforts by several pulmonary groups to get CMS to reconsider its national coverage determination for vents. In particular, the groups want the agency to clinically define respiratory failure and mechanical ventilators/ventilation; and create objective, consistent criteria for providing the products.