The CQRC remains committed to protecting access to home respiratory therapy and advocates for policies that support patient-centered care and create economic stability. We support payment policies that align with the Congressional intent not to expand competitive bidding to rural areas. We support prior authorization and other common sense policies to eliminate the quagmire of the current audit process. Most importantly, the CQRC wants to make sure that Medicare beneficiaries who require life-sustaining non-invasive ventilation therapy so they can remain in their home with their families have access to it.
At the end of July, the Congress was one Member short of passing DME rule relief. This bill would have retroactively extended the phase-in to allow more time for policy-makers to understand the impact of the draconian 50 percent or more cut to home respiratory therapy suppliers. The Congress can still provide relief, but must act NOW! Learn More
CQRC supports policies that reduce the overwhelming audit burden that delays payments to suppliers and leads to patients having to provide co-payment amounts that have compounded during the audit appeal process. CQRC believes the best way to fix this problem is to learn from the private sector an implement electronic prior authorization for home respiratory therapy.
CQRC supports the Medicare competitive bidding program, if it is implemented properly. The problems with the current methodology continue to lead to rates that do not reflect the cost of providing services. As many commenters have described over time, the issues of non-binding bids, licensing issues, median price bids, composite bids, inability to find a clearing price, and a lack of transparency, taken together, lead to an arbitrary pricing scheme. Although CMS has made some efforts to improve the program, evidence has arisen to suggest that problems still exist.
While it is important that Medicare protect the integrity of the program, coverage policies need to be clear so that beneficiaries who need of home ventilation therapy can access it.
Millions of Americans are living with COPD and Obstructive Sleep Apnea, experiencing acute respiratory failure, or living with neuromuscular diseases. These individuals rely upon home respiratory therapies to remain at home. Learn more about home respiratory therapies and how they can help.
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