miércoles, 28 de noviembre de 2012

Medicare Coverage Document (MCD) for Potential NCD Topics

Medicare Coverage Document (MCD) for Potential NCD Topics

Centers for Medicare & Medicaid Services 

Public Comment Period:
N/A - N/A   
Previously, CMS invited the public’s input concerning any items and services that may be inappropriately used (i.e., underused, overused, or misused) or provide minimal benefit in hospitals, clinics, emergency departments, doctors’ offices, or in other healthcare settings.[1] CMS also expressed interest in public input on items or services that might improve health outcomes and are not currently covered.  CMS asked the public to be specific about items and services including surgical procedures, diagnostic tests or procedures, imaging or radiology services, lab tests, or durable medical equipment (such as glucose monitors or wheelchairs); treatments for diseases such as cancer, heart disease, kidney disease or gastrointestinal disease; or procedures such as orthopedic or eye procedures. 
 We reviewed and evaluated all of the submissions and believe that many of the suggested topics may be suitable candidates for further review.  Some of these topics may have the potential to be subjects for further evaluation using literature reviews, claims based analyses, or as subjects for analysis in a National Coverage Determination (NCD). In considering topics for inclusion on our list we assessed our current policies and the availability or absence of evidence based guidelines and other pertinent medical literature.  We also weighed their relevance to the scope of the Medicare benefits under Part A and Part B and the NCD authority and the potential impact on the Medicare program and on Medicare beneficiaries. In addition to the publicly submitted topics, we also added three topics of interest to CMS (intraaortic balloon pumps and paracorporeal ventricular assist devices, lap-band surgery for obesity and kyphoplasty).
The items and services added by CMS are based on our internal consideration of the medical literature, Medicare claims experience of the MACs, horizon scans of medical literature, and interactions with the stakeholder community at various scientific meetings.  Below is the complete list of potential NCD topics.  We look forward to continued public dialogue and input regarding CMS coverage policy.

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