have introduced a bill to delay the inclusion of ventilators from CMS’s competitive bidding program for five years.
The bill, The Safeguarding Medicare Access to Respiratory Therapy (SMART) Act, would also create an expert panel that would advise the Department of Health and Human Services on how to develop Medicare coverage policies for ventilators used at home.
Led by Rep. Morgan Griffith (R-Va.) and Rep. Peter Welch (D-Vt.), the new legislative effort reflects frustration from the HME industry and legislators over how the decision would affect patient access to ventilators. Reps. John Larson (D-Conn), Darren Soto (D-Fla.) and Gus Bilirakis (R-Fla.) also signed on to co-sponsor the legislation.
Tom Ryan, president and CEO of the American Association for Homecare, said that the legislation takes a “smart approach” to ensuring that patients can benefit from innovations in ventilatory technology.
“If we subject these products to a reimbursement methodology primarily designed to identify lowest-cost providers, we’re going to severely reduce the ranks of companies with the experience and clinical expertise needed to serve vulnerable patients,” Ryan said in a statement.
He added that the association supports “expert-led efforts” to update Medicare ventilator coverage policy and reduce the need for more costly clinical interventions.
Before the introduction of the legislation on Oct. 31, Griffith and Welch sent a House sign-on letter to CMS Administrator Seema Verma and HHS Secretary Alex Azar in May urging the administration to walk back its decision to include non-invasive ventilators from Round 2021 of bidding. That letter received 180 signatures from a bipartisan group of House lawmakers.
AAHomecare and the legislators said that Verma’s October response was insufficient and decided to move forward with legislative solutions.
“Respiratory care professionals and patient advocate groups have been united in their opposition to including ventilators in the bidding program,” Ryan said. “The home medical equipment community is ready to stand with them and advocate for prompt consideration and passage of the SMART Act.”