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Ventilation Devices: Reasonableness of Medicare Payments Compared to Amounts Paid in the Open Market

Medicare reimbursement for ventilation devices has risen from $51 million in 2011 to $72 million in 2015. However, unlike similar items for which Medicare has seen reduced costs through competitive bidding, ventilation devices have not been competitively bid. We will determine the reasonableness of the fee schedule prices that Medicare and beneficiaries pay for ventilation devices compared to prices on the open market to identify potential wasteful spending in the Medicare program.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
August 2017 Centers for Medicare & Medicaid Services Ventilation Devices: Reasonableness of Medicare Payments Compared to Amounts Paid in the Open Market Office of Audit Services W-00-17-35803; A-05-xx-xxxxx 2020