Health Policy and Advocacy Committee Activities

OCTOBER 2020

Health Policy and Advocacy Committee Activities

In recent reports to the CHEST Board of Regents, Health Policy and Advocacy Committee (HPAC) Chair Neil Freedman, MD, FCCP, presented updates on the five main activities HPAC has focused on in the last few months:

• Planning and executing an external Technical Expert Panel (TEP) at the request of the Centers for Medicare and Medicaid Services (CMS) on noninvasive ventilation (NIV) outside of the hospital. The original coverage criteria for the reimbursement of NIV for Medicare beneficiaries were primarily based on the 1998 consensus conference report recommendations (Chest. 1999;116:521-534). Over the last two decades, important changes in clinical practice and pertinent new clinical evidence have emerged and a reevaluation is long overdue. The current NIV reimbursement criteria have resulted in problematic regulatory barriers for reimbursement of NIV necessary to appropriately support these patients. A multisociety coalition of the American Academy of Sleep Medicine, the American Association of Respiratory Care, the American Thoracic Society, and CHEST created a TEP, which met virtually on October 3-4 to recommend updates to the regulations. An initial summary of this meeting appears in this issue of Washington Watchline and more specific outcomes will be presented in upcoming issues as the TEP’s efforts continue.
• Comment on the National Coverage Determination (NCD) on Home Use of Oxygen (240.2). As the current NCD was established in 1993, when CMS presented the opportunity for comment in September, HPAC recognized the importance for CHEST members and our patients to recommend necessary changes. Within a week of the deadline, a group of experts (Drs. Dennis Doherty, Gerard Criner, Jim Lamberti, Robert De Marco, and Neil Freedman) crafted comments to CMS which were endorsed by 10 additional organizations and submitted to CMS.

• The CHEST/ATS Joint Clinical Practice Committee and CHEST HPAC commented on the overall 2021 Medicare Physician Fee Schedule. A summary of these comments is presented later in this issue.
• Collaborative work on “oxygen toolkit” continues. HPAC and the CHEST Foundation continue to work together with the American Association of Homecare in reviewing and building the “oxygen toolkit” addressing efforts in oxygen prescribing education and patients’ and caregivers’ oxygen use education.
• Tobacco-dependence toolkit revision. HPAC members in the tobacco/vaping area are working to revise CHEST’s tobacco dependence treatment toolkit and other patient-and clinician-focused resources.

Dr. Freedman encourages all members to be aware of the committee’s activities as an integral part of the practice of chest medicine. Responding to calls to action as well as working within CHEST Networks to support advocacy efforts will strengthen the voice for the best care for patients. Members interested in participating in committee activities should contact advocacy@chestnet.org.

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