New Legislation Would Exclude Non-Invasive Ventilators from Competitive Bidding

WASHINGTON, D.C. (November 4, 2019)—Two United States representatives have introduced legislation to protect patient access to non-invasive ventilators, the American Association of Homecare reports. HR 4945, the Safeguarding Medicare Access to Respiratory Therapy (SMART) Act, sponsored by Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.), would delay for five years the inclusion of ventilators from the Medicare competitive bidding program for home medical equipment and create a technical expert panel to assist the Department of Health & Human Services in developing a comprehensive Medicare coverage policy for ventilator products used at home.

“Medical ventilators are life-sustaining devices. Patients depending on them can often remain in their homes, but only if providers are able to travel to them. This becomes more difficult in rural or isolated areas, such as parts of Virginia’s Ninth Congressional District, and introducing competitive bidding would likely be an unsustainable burden to providers in these areas,” Griffith said in a news release. “The SMART Act would prevent such difficulties. I am pleased to stand with my colleagues from both sides of the aisle in support of our constituents who rely on ventilators.”

“Non-invasive ventilators improve patient outcomes and allow patients to be at home surrounded by family,” Welch said in a news release. “Recent decisions by (the Centers for Medicare & Medicaid Services, or CMS) threaten to make it harder for patients in rural and underserved areas to access this critical equipment. This bill would make sure that all patients can benefit from this technology, no matter where they live.”

Twenty-four organizations representing patients, clinicians and health care providers signed a letter October 31 in support of the SMART Act, including AAHomecare, the American Lung Association, the National Association for Homecare and Hospice, the U.S. COPD Coalition and more.

“Respiratory care professionals and patient advocate groups have been united in their opposition to including ventilators in the bidding program,” said AAHomecare President and CEO Tom Ryan. “The home medical equipment community is ready to stand with them and advocate for prompt consideration and passage of the SMART Act.”

“Ventilators are commonly described as ‘life support systems’ for the individuals who depend on them,” Ryan said. “If we subject these products to a reimbursement methodology primarily designed to identify lowest-cost providers, we’re going to severely reduce the ranks of companies with the experience and clinical expertise needed to serve vulnerable patients.”

“The SMART Act takes a smart approach to making sure that respiratory patients can benefit from advances in ventilator technology,” he added. “We believe that expert-led efforts to update ventilator coverage policy will ultimately improve patient outcomes and reduce the need for more costly clinical interventions.”

Congress has already signaled interest in protecting patient access to ventilators, as seen in sign-on letters in both chambers urging CMS to reconsider plans to add non-invasive vents to the bidding program. The House letter on non-invasive ventilators in late June garnered 180 signatures, and a Senate letter in early July tallied 38 signatures in just one week’s time.

Other original cosponsors include Reps. Gus Bilirakis (R-Fla.), John Larson (D-Conn.), and Darren Soto (D-Fla.). The full text of the bill is available here.