July 8, 2025 | VOLUME 3, ISSUE 2
Access to care is a foundational element of health equity and a key pillar of the health care system. It encompasses multiple components, including affordability and insurance coverage, timeliness, and availability and accessibility, with the goal of achieving optimal health outcomes. CHEST’s work within this advocacy pillar has included various approaches to improve patients’ abilities to receive evidence-based screening, prevention, diagnosis, and management across the pulmonary, critical care, and sleep medicine fields.
Recently, CHEST has participated in advocacy efforts to improve access to lung cancer screening, supplemental oxygen, and noninvasive ventilation.
Increasing Access to Lung Cancer Screening Act
The Increasing Access to Lung Cancer Screening Act was introduced in the US House of Representatives in 2023. The bill aims to improve patient access to lung cancer screening by providing coverage without cost sharing for lung cancer screening, expanding coverage for tobacco cessation pharmacotherapy and counseling, eliminating prior authorization requirements for lung cancer screening, and establishing a lung cancer screening education and outreach campaign at the US Department of Health and Human Services. CHEST, as a member of the Early Lung Cancer Coalition led by the LUNGevity Foundation, has worked to advance the bill, which has garnered bipartisan support.
The Supplemental Oxygen Access Reform Act
The Supplemental Oxygen Access Reform (SOAR) Act was initially introduced to Congress in 2024 before being reintroduced in February 2025. The bill aims to remove all oxygen services and equipment from competitive bidding reimbursement, decreasing costs for patients and improving access to portable high-flow oxygen. These changes would require an overhaul of the current Medicare reimbursement system for supplemental oxygen and related services. Along with more than 30 patient, health care professional, and industry organizations, CHEST is urging Congress to pass the SOAR Act, which is critical to ensuring individuals can access the oxygen treatment and services they need to live healthy and fuller lives.
Noninvasive Positive Pressure Ventilation in the Home for the Treatment of Chronic Respiratory Failure Consequent to COPD
In 2021, CHEST, along with the American Thoracic Society, American Association for Respiratory Care, and American Academy of Sleep Medicine, published a Technical Expert Panel Report, “Optimal NIV Medicare Access Promotion: Patients With COPD.” Subsequently, representatives from CHEST and the collaborating societies sent a letter to the US Centers for Medicare & Medicaid Services (CMS) requesting revision of the national coverage determination for noninvasive ventilation (NIV) in the treatment of chronic respiratory failure related to COPD. CMS accepted the request and initiated a national coverage analysis in September 2024.
A proposed decision memo was issued by CMS in March 2025, and CHEST provided comments to help simplify and clarify the coverage criteria while reducing barriers to patient access. CHEST advocated for the removal of the overnight oximetry requirement and development of a more comprehensive policy that would allow patients to receive either a bilevel positive airway pressure device with a backup rate or a home mechanical ventilator depending on their specific needs and requirements. CHEST also advocated for a more simplified and practical approach for patient follow-up and evaluation of benefit when considering ongoing coverage for continued use of these devices.
The final National Coverage Determination was released in June 2025, and the first-draft guidelines included almost everything that was recommended by CHEST’s COPD technical expert group.