CMS relents on vents

WASHINGTON - Getting non-invasive vents dropped from Round 2021 of competitive bidding is a big deal but there's a case to be made for delaying the entire program, industry stakeholders say.

“That's going to be a three-year stay of execution (for NIV) and I think it was appropriate given the Defense Production Act and the public comments,” said Tom Ryan, president and CEO of AAHomecare. “But we need to get the agency to postpone the program for at least a year.”

Round 2021 is schedule to go into effect Jan. 1. CMS is expected to announce payment amounts this summer and contract suppliers in the fall.

The challenges providers are facing trying to care for patients amid the coronavirus pandemic are good reason to delay the program, stakeholders say.

“There are backlogs, there are surcharges—the pricing structure has changed because of the shortages and allocations (of equipment),” Ryan said.

With a potential second wave of COVID-19 cases expected this fall, pausing the program would allow any willing provider to continue offering services, say stakeholders.

“It's all about capacity,” said John Gallagher, vice president of government relations for VGM. “During a public health emergency, why would you reduce capacity when you need it.”

Additionally, stakeholders are drafting legislation that would establish a 75/25 blended reimbursement rate in bid areas. The recently passed CARES Act established a 75/25 rate for non-rural, non-bid areas retroactive to March 6 for the duration of the emergency.

“We're working on legislation that would give us that relief, as well,” said Ryan. “We've got good consensus around the language and we need to build traction.”

Despite all the challenges faced by the industry, stakeholders say providers have really stepped up and an initial wave of relief payments that began last week should provide a boost.

“They work hard—we are considered essential services,” Ryan said. “That money is not a loan, that's yours to use to work through the costs of care during this crisis.”