Centers for Medicare and Medicaid Services (CMS) received a formal request to review the national coverage policy on air-fluidized beds. We are reviewing the current clinical evidence on the home use of air-fluidized beds to treat Stage III and Stage IV pressure ulcers. Based on this request and our initial analysis, we are reviewing certain aspects of our current national coverage policy, as well as evidence on the comparative effectiveness of air-fluidized therapy relative to the effectiveness of powered pressure reducing air mattresses (alternating pressure low air loss or powered flotation without low air loss). We also are seeking to define what sub-population of patients would benefit from air-fluidized therapy and/or powered pressure reducing air mattresses.
In particular we are seeking evidence to determine if modifications to the revised national coverage policy on air-fluidized beds, which was effective November 1, 2000, are necessary. We will review the requirements of conservative treatment that must be tried before initiating air-fluidized therapy to determine if a policy exception to the conservative care requirement would be appropriate. In particular, we will examine the requirement for use of a Group II support surface, either in or out of the hospital, for one month prior to initiating air-fluidized therapy.
We ask that any interested party knowledgeable in this matter send evidence to CMS for home use of air-fluidized beds. In particular, the formal request asks that we consider the following:
After reviewing evidence received on this posting, we determined that there are additional aspects that require further review. Therefore, we are requesting that the Agency for Health Research and Quality (AHRQ) assist us in a review and assessment of peer reviewed scientific literature and other evidence in an attempt to determine the specific benefit of air-fluidized beds when compared to the use of other support surfaces in the treatment and prevention of decubitus ulcers. We are also interested in what constitutes appropriate wound care while a patient is on an air-fluidized bed. Therefore, we submitted a request to AHRQ to conduct further analysis on this issue. The following represents the draft questions that we are asking AHRQ to consider while doing its review: