CHEST’s Health Policy and Advocacy Committee (HPAC), in collaboration with the American Academy of Sleep Medicine, the American Association for Respiratory Care, and the American Thoracic Society, recently submitted a Technical Expert Panel (TEP) report to Medicare on the need for updates to the national coverage determinations (NCDs) for home noninvasive ventilation (NIV).
“The current NCDs for NIV patients with thoracic restrictive disorders, COPD, and hypoventilation syndromes conflict with new literature and don’t reflect the rapidly evolving technology in the field,” said Peter C. Gay, MD, MS, FCCP, Chair of the TEP and HPAC committee member. “They have long needed to be updated to ensure that patients on Medicare have optimal access to potentially lifesaving equipment.”
Dr. Gay will chair the session The Home NIV Expert Panel Report to Medicare: RTD, COPD and CRF/HMV on Wednesday at 8:00 am CT. He will be joined by members of the TEP, who will summarize the findings of their subcommittee reports for restrictive thoracic disorders (RTDs), COPD, and central sleep apnea (CSA).
On September 10, the final TEP report was sent to CMS with the consensus proposal to revise NIV coverage completely. CMS now has up to 6 months to consider the proposal and post an agreement to open the current NCD. Within 60 days of that agreement, the initial NCD Reconsideration will be posted for a final 30-day commentary period before the NCD is finalized.
“It’s been a long process, but we needed to get this done right, and we did,” Dr. Gay said. “So, there will be new rules and, ultimately, we expect this will improve all NIV CMS coverage policies and guarantee the right device for the right patient at the right time.”
Read the full TEP report and recommendations published in the CHEST® journal:
- ONMAP Executive Summary
- Thoracic Restrictive Disorders
- Central Sleep Apnea
- Hypoventilation Syndromes
- Failed CPAP for OSA
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