CMS seeks comment on NIV decision

WASHINGTON – CMS has released a proposed decision in response to the request for reconsideration of NCD 280.1 to establish coverage policies for the use of noninvasive home mechanical ventilators and respiratory assist devices for Medicare beneficiaries with COPD. 

Read CMS’s proposed decision here. 

The decision, according to AAHomecare, includes expanded coverage for RADs - with and without a backup rate feature - and home mechanical ventilators. Notably, the association says, it proposes coverage for HMVs in volume-targeted mode for individuals with chronic renal failure due to COPD who meet specific clinical criteria.

CMS, which will develop a new national coverage determination section, is soliciting public comment on the decision until April 10. 

“We are particularly interested in comments that include scientific evidence, specifically any peer-reviewed literature, that describes the role of BPAP or HMVs in the home management of chronic respiratory failure in patients with COPD,” the agency stated. “We are also interested in aspects of health disparities and health equity that should be considered in the review.” 

The request to reconsider NCD 280.1 was made by The Optimal Noninvasive Ventilation Medicare Access Promotion Technical Expert Panel (TEP) consisting of representatives from the American College of Chest Physicians, the American Academy of Sleep Medicine, the American Association for Respiratory Care and the American Thoracic Society.   

CMS opened an initial public comment period on the request in September and plans to complete its analysis in June 9, 2025. 

• Read CMS’s proposed decision memo here. 
• Submit comments on its decision here.