Vent bill drops in Senate

Thursday, July 14, 2016

WASHINGTON – A bill that seeks to preserve access to ventilators for Medicare beneficiaries was introduced in the Senate today.

The “Beneficiary Respiratory Equipment Access and Transparency to Home Ventilator Care (BREATH) Act of 2016,” introduced by Sens. Bill Cassidy, D-La., and Chuck Grassley, R-Iowa, seeks to establish policies and standards for appropriate use of ventilators in consultation with medical experts; and to increase reimbursement rates for home ventilation by 20%.

In response to a spike in utilization for non-invasive vents, CMS has made sweeping changes to the product category, including reducing the number of codes from five to two, and reducing reimbursement by about 33%.

In May, the DME MACs released guidance that removed the so-called “imminent death requirement,” which stated that patients must need a ventilator 24/7 for coverage.