American College of Chest Physicians Leads Landmark Effort to Improve Access to Lifesaving Noninvasive Ventilation for Patients With COPD
September 16, 2025
GLENVIEW, IL – The American College of Chest Physicians (CHEST) announces a critical milestone in its long-standing advocacy to ensure patients with COPD receive timely access to the most appropriate noninvasive ventilation (NIV) therapies. After more than a decade of strategic efforts led by CHEST, the Centers for Medicare & Medicaid Services (CMS) recently released a proposal that includes substantial changes to federal coverage guidelines for NIV devices used in the home.
These proposed guidelines, addressing coverage of noninvasive positive pressure ventilation for patients with chronic respiratory failure due to COPD, reflect nearly all of the major recommendations submitted by a CHEST-convened expert panel.
“We are thrilled that CMS has embraced recommendations that will directly enhance patient care in noninvasive ventilation,” said Nicholas Hill, MD, Chair of the CHEST-initiated COPD technical expert panel. “This is the culmination of years of collaborative work by CHEST and the broader respiratory health community, and it is encouraging to see that advocacy leads to real change.”
In 2021, CHEST organized and led technical expert panels to produce comprehensive recommendations for the use of NIV across respiratory conditions, including COPD, OSA, central sleep apnea, thoracic restrictive disorders, and hypoventilation syndromes. The report on COPD supported the submissions to CMS that led to the changes.
The World Health Organization estimates that COPD is the fourth-leading cause of death worldwide, leading to 3.5 million deaths in 2021, and the global community's eighth-leading cause of poor health. Evidence also suggests that a significant number of people across the globe live with undiagnosed COPD.
NIV is proven to improve quality of life and survival in patients with COPD. Yet outdated or inconsistent coverage policies have historically forced patients and physicians to navigate burdensome barriers, sometimes resulting in inappropriate device use or delayed care. CHEST’s advocacy directly targeted these challenges, calling for policies that streamline access and ensure clinical decisions are driven by patient needs rather than administrative hurdles.
“This is a good sign that progress is being made in the right direction,” said Peter Gay, MD, FCCP, member of the CHEST-initiated COPD technical expert panel. “And we will keep working to share evidence-based arguments until these changes are solidified and can improve the lives of our patients.”
This achievement underscores the substantial, sustained efforts by CHEST members and partners to place patient care at the heart of policy decisions. CHEST continues to advocate to ensure the final guidelines uphold these gains, reduce disparities, and secure equitable, timely access to lifesaving respiratory therapies for all patients with COPD.
For more information about CHEST’s advocacy work, visit https://www.chestnet.org/membership-and-community/advocacy.
About the American College of Chest Physicians
The American College of Chest Physicians® (CHEST) is the global leader in the prevention, diagnosis, and treatment of chest diseases. Its mission is to champion the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. It serves as an essential connection to clinical knowledge and resources for its 18,000+ members from around the world who provide patient care in pulmonary, critical care, and sleep medicine. For information about CHEST and its family of journals, including the flagship journal CHEST®, visit chestnet.org.