CMS seeks input on NIV

WASHINGTON – CMS is soliciting public comment on a request for reconsideration of NCD 280.1 to establish coverage policies for the use of noninvasive home mechanical ventilators and respiratory assist devices for Medicare beneficiaries with COPD.  

The scope of the agency’s national coverage analysis (NCA) is limited to noninvasive positive pressure ventilation in the home for the treatment of chronic respiratory failure consequent to COPD and will focus on clinical indications for the initial and continued use of bi-level positive airway pressure (BPAP) devices and home mechanical ventilators (HMV), as well as the characteristics of these devices. 

As part of the NCA, CMS will analyze the clinical evidence for outcomes that may include improvement of physiologic signs along with decreased mortality, decreased frequency of exacerbations requiring emergency room or hospital admission, increased time to hospital re-admission for respiratory related disease, and improved function and quality of life. 

The agency is especially interested in comments that include scientific evidence, specifically any peer-reviewed literature, that describes the role of BPAP or HMV devices in the home management of chronic respiratory failure in patients with COPD. It is also interested in aspects of health disparities and health equity that should be considered in the review. 

The request to reconsider NCD 280.1 was made by The Optimal Noninvasive Ventilation Medicare Access Promotion Technical Expert Panel (TEP) consisting of representatives from the American College of Chest Physicians, the American Academy of Sleep Medicine, the American Association for Respiratory Care, and the American Thoracic Society. 

CMS is collecting comments here. 

Related: 

• In July, AAHomecare engaged Dobson Davanzo & Associates to quantify the differences in outcomes and overall treatment costs for patients with significant respiratory challenges who receive non-invasive ventilation (NIV) therapy versus those who don’t. 

• Earlier this month, the association launched a portal to collect end user and family caregiver stories about the impact of policy changes for NIV.