CMS Releases NIPPV Proposed Decision Memo Expanding RAD & HMV Coverage

WASHINGTON—The Centers for Medicare & Medicaid Service (CMS) published a proposed decision memo on using noninvasive positive pressure ventilation (NIPPV) at home to treat chronic respiratory failure (CRF) connected to COPD, the American Association for Homecare (AAHomecare) reported. 

In the memo, CMS outlines several key proposals, including expanded coverage for respiratory assist devices (RADs)—both with and without a backup rate feature—as well as home mechanical ventilators (HMVs). 

“Notably, CMS proposes coverage for HMVs in volume-targeted mode for individuals with CRF due to COPD who meet specific clinical criteria,” AAHomecare said in a notice to members. The full memo is available here. 

The release of the memo follows the release of the national coverage analysis (NCA) with comment period last fall, during which AAHomecare submitted comments urging CMS to establish clear and objective medical need criteria for coverage. 

AAHomecare said it is currently reviewing the proposed decision memo and will be developing formal comments. CMS is accepting public comments on the Proposed Decision Memo until April 10, 2025. Stakeholders are encouraged to review the proposal and submit feedback to help shape the final coverage determination.