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Home News CMS Proposes Adding Ventilators to Competitive Bidding; AAHomecare Pushes Back

In late 2018, CMS requested feedback on the inclusion of ventilators (E0465, E0466, E0467) and braces in the DMEPOS competitive bidding program. AAHomecare responded with comments strongly opposing inclusion of ventilators to the program due to the complexity of providing ventilator services to patients and due to the intensive and continual care these patients need. Ventilators are life support systems that replace or support normal ventilatory lung function, it is a DME item that is unlike any other competitively bid item.

AAHomecare’s comments also pointed out that Medicare currently classifies ventilators in a category of items that require “frequent and substantial servicing,” recognizing the intensive and continual service these items require “in order to avoid risk to the patient’s health,” and notes that Medicare has not included any other “frequent and substantial servicing” items in the bidding program to date.
 
Due to the changes being made to the structure of competitive bidding in the next round, which is slated to begin in 2021, AAHomecare does not believe it is an appropriate time for CMS to add ventilators, braces, or any other new product categories to the mix. 
 
You can find AAHomecare’s comments here.


Ohio Hospital Echoes AAHomecare’s Concerns

The prospect of adding ventilators to the bidding program has also raised concerns with clinicians and caregivers who support the vulnerable patient cohort who rely on these products.  Comments by Nationwide Children’s Hospital in Columbus, Ohio provided examples of how ventilators dramatically improve the lives of young patients with significant respiratory challenges and provided a stark warning on the potential impacts of adding these products to the bidding program:
 
Adding ventilators to the competitive bidding process for Medicare would be a failure at the start and would adversely affect every single pediatric patient in Ohio who uses some form of ventilation for support.  Changing the rates of payment for services would essentially put many if not all of these dedicated companies out of business.  This would lead to detrimental consequences for the patients they serve.
 

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