CMS Responds to Ventilator Sign-on Letter

WASHINGTON, D.C. (October 25, 2019)—The Centers for Medicare & Medicaid Service (CMS) has responded to members of the House of Representatives who joined a Congressional sign-on letter asking the Department of Health and Human Services (HHS) and CMS to reconsider plans to include non-invasive ventilators in Round 2021 of the competitive bidding program.

In a response sent individually to the 180 House members who joined the June 2019 sign-on letter, CMS Administrator Seema Verma asserts that Medicare has numerous safeguards in place to protect beneficiary access, including making sure that suppliers meet quality standards and availability to provide service 24 hours a day.

The response fails to address central tenets of the House sign-on letter, including the idea that “the adequacy of Medicare payment for critical services like home ventilatory care is paramount” and the fact that CMS has not previously included items requiring frequent and substantial servicing in the bidding program.

CMS’s response underscores the need for a legislative solution to keep non-invasive ventilators out of the bidding program. Congressional champions on this issue are expected to release a bill on NIV in competitive bidding soon. A strong grassroots campaign in support of this legislation from the HME community and allies in the patient advocacy community will be needed to keep these life-support systems out of the bidding program.

Rep. Griffith Notes Response Letter and Urges Administrator Verma to Reconsider Plans to Include NIV in CB During Oversight Hearing
Rep. Morgan Griffith (R-Va.) made the case for keeping non-invasive ventilators out of the bidding program in a hearing on administration health care policy by the Oversight & Investigations Subcommittee of the House Energy & Commerce Committee on Wednesday, Oct. 23:

“Earlier this year, it came to my attention that CMS planned to include non-invasive ventilators in Medicare’s competitive acquisition program for durable medical equipment. In June, [Rep. Welch] and I led a letter signed by 180 of our colleagues expressing concern about that decision. I support the goal of ensuring financial responsibility in health care, but I’m not convinced this method is appropriate in every situation. Until we know that access to a critical piece of medical equipment won’t be compromised, I don’t think we should be making monumental changes to the acquisition process.”

“I just got your letter yesterday afternoon in response to that letter, where you said we’re not going to do it on invasive, but here’s the problem I have: I have a rural district, as does my friend Mr. Welch. What happens is that if you go to this cost-only issue, you’re going to make someone drive 45 minutes to an hour…if the low-cost supplier is only located in town. I would ask you to really take a look at that because in the rural districts, our folks are not going to get served.”

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