Respiratory Industry Fights CPAP Bundling

Providers, AAHomecare, VGM, vendors, other stakeholders form unified front against CMS’s plan for bundled pricing for CPAPs and supplies.

The American Association for Homecare, the VGM Group Inc. and various respiratory stakeholders and groups such as AdvaMed and the Council for Quality Respiratory Care have been developing a unified response to CMS’s plan to bundle CPAP devices and supplies.

CMS first announced the plan as part of its Round 2019 announcement, saying it planned to bundle CPAP devices, consumable items, maintenance and service into a single monthly payment. While CMS subsequently delayed its Round 2019 plans, the prospect of CPAP bundling would cause disruption for providers and patients, because it would force an "increased reliance on inferior, low-cost items that patients would have to use throughout the duration of their care," according to AAHomcare.

The association reported it had researched legislation and other regulations pertaining to the bidding program and concluded that CMS’s competitive bidding authority doesn’t give the agency authority to bundle bidding programs for CPAPs and related items, or other HME categories.

"Payment models for CPAP should not jeopardize patients’ access to the specific equipment best suited to their needs, or the quality of care they receive," said Larissa D’Andrea, director of government affairs for respiratory and sleep equipment maker ResMed. "Bundling may also be problematic for patients: it could substantially increase copayments and out-of-pocket expenses for beneficiaries. Plus, layering untested bundled payments on top of expanded Competitive Bidding Program rates could compound existing access challenges caused by these other cuts."

AAHomecare reported it and its partners would encourage CMS to explore approaches that will allow providers to continue offering high-quality equipment, and for CMS to consider the need to maintain patient satisfaction and improved clinical outcomes for CPAP users.  

The association said it would release the full text of a forthcoming letter to CMS addressing the issue, and will continue to press the issue with CMS and on Capitol Hill.  

About the Author

David Kopf is the Editor of HME Business.

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