Posts Tagged CMS

Danger: Bidding Ahead

April 16th, 2014 | Author: Rebecca Rudolph

Like many COPD patients nationwide, you may have experienced trouble accessing home oxygen equipment due to the Centers for Medicare and Medicaid (CMS) program called competitive bidding. This alarming practice has prevented members of our community from accessing life-saving therapies. The COPD Foundation wants you to know we are on it.

What is Competitive Bidding?

Competitive bidding is changing the way that CMS pays for home oxygen supplies. It requires durable medical equipment (DME) companies to apply and be awarded contracts by CMS in order to be providers

(www.rjhedges.com)

(www.rjhedges.com)

for CMS patients. We have seen firsthand how the competitive bidding process has negatively impacted the COPD community by preventing access and causing anxiety among patients, caregivers, and their healthcare providers.

We have been working hard on the competitive bidding issue for two years, but gridlock in Congress has prevented the passage of legislation – making change in the healthcare system difficult. As a result, we have decided to speak directly to CMS through a process known as “submitting comments.”

Why We Have Submitted Comments

There are many benefits to submitting comments to CMS:

  • Comments are an effective way to inform CMS about the negative implications of competitive bidding to patients;
  • CMS takes all comments, including the patient voice, into sincere consideration when making decisions on programs and policy; and, CMS is required by law to respond to all comments as final decisions are made on its’ programs.

Outside of submitting comments to CMS, the COPD Foundation is also lobbying in support of H.R. 1717, the Medicare DMEPOS Pricing Program Act of 2013, which proposes an alternative to the competitive bidding program. Find more information about the bill here.

All COPD patients, or those interested in the issue, should visit our Issue Central page where you can read the comments and sign-on letter.

If you have experienced difficulty accessing your home medical equipment contact the C.O.P.D. Information Line (1-866-316-2673). Our Information Line associates will then officially file the complaint with Centers for Medicare and Medicaid Services.

Help us help you by completing this survey.

Medicare Open Enrollment–Happening Now!

October 18th, 2011 | Author: Katelyn Turner

The Centers for Medicare & Medicaid Services (CMS) Read more…

LVRS and Lung Transplant 101

January 31st, 2011 | Author: Katelyn Turner

Photo by shawnzrossi

For many COPDers, lung volume reduction surgery or lung transplantation are two topics of conversations they’ve already had with their pulmonologists. Though it might not be an option for some COPDers, others find surgery as the best route to breathing and living better with COPD. In this blog, I’d like to take a moment to talk about the two procedures and how some people prepare for the big day.

Lung Volume Reduction Surgery, LVRS, is a surgery that’s become more common recently but was developed years ago. LVRS does what it stands for: it surgically reduces the size of your lungs in order to help your lungs function better. According to the physicians who wrote the COPD Big Fat Reference Guide ®, LVRS is based on two beliefs. First is that a removal of a nonworking areas of the lungs allow less affected areas to expand into that space leading to more efficient lung function. The second belief is removing areas of the lung are over-inflated and nonworking, making the lungs smaller and more efficient.

Back in the 1990s, the National Institutes of Health and the Centers for Medicare and Medicaid Services (CMS) funded a study called the National Emphysema Treatment Trial, or NETT. NETT set out to find out with LVRS was in fact beneficial to patients and develop some sort of criteria for identifying COPDers who would benefit from the surgery. 1,218 individuals were selected for the trial, and about half (608) were scheduled to have LVRS. Researchers found out that, on average, COPDers with severe emphysema who underwent LVRS were more likely to breathe better and don’t face an increased risk of death for having the surgery. There were some critical risks identified, however.

Lung transplantation is a more involved approach to improving a COPDer’s lung function and is reserved for extremely severe diseases. There are strict criteria a COPDer must follow in order to be eligible, including not having any other diseases and have a stable enough mental state to tolerate the stress surrounding the surgery. There are many decisions to be made, including getting a single or double lung transplant.

Everyone who is qualified for a lung transplant needs to get on a list to wait for a donor (read about the list on UNOS.org). If you’re already on the list for transplant, check out this handy checklist from the Cleveland Clinic to help you get ready for the big day.

Though the surgery can be intense, many COPDers have found it to give them their lives back. These two procedures aren’t for everyone but talk to your doctor if you feel this might help you.