CMS Might Add Ventilators, Braces to Bidding

Agency is currently soliciting public comments on the expansion; MedPAC had earlier identified comparatively high reimbursement for ventilators under Medicare.

• By David Kopf
• Nov 15, 2018

CMS is planning on adding ventilators and back and knee braces to the next round of competitive bidding and is seeking public comments on that plan.

Readers might recall that in June The Medicare Payment Advisory Commission’s (MedPAC) identified ventilators as among the non-competitively bid products that Medicare spends the most on, and recommended expanding the program.

In its announcement, CMS listed the various codes it was considering:

• Ventilators: E0465, E0466, E0467
• Off-The-Shelf Back Braces: L0450, L0455, L0457, L0467, L0469, L0621, L0623, L0625, L0628, L0641, L0642, L0643, L0648, L0649, L0650, L0651
• Off-The-Shelf Knee Braces: L1812, L1830, L1833, L1836, L1848, L1850, L1851, L1852

“These new product categories will be phased-in under all competitive bidding areas in the next round of the DMEPOS Competitive Bidding Program,” the announcement read.

CMS is taking public comments until11:59:59 PM Prevailing Eastern Time on Dec, 3. Providers should email comments to [email protected] with the subject line “Competitive Bidding Product Categories.”

Both the American Association for Homecare and VGM Government Relations said they were opposed to adding any of the products, and underscored the need to protect ventilators in particular.

“The thought of bidding such vital, life-sustaining equipment such as an invasive ventilator is extremely concerning given the fact that there is a small provider population serving that venerable market,” a statement from VGM read.

“The prospect of adding ventilators to the bidding program should worry patients who depend on these highly specialized and service-intensive products, as well as clinicians and other caregivers who support this often-vulnerable patient population,” added AAHomecare.