Medicare coverage process
This article was originally published in The Gray Sheet
Recently released Health Care Financing Administration notice describing procedures and timeframes for obtaining coverage decisions ("The Gray Sheet" April 26, p. 3) fails to provide an "opportunity for stakeholders to have an early, collaborative meeting with" HCFA staff "so that a written, mutual agreement may be reached on what specific information" is needed to make a coverage determination, Medical Alley says in an April 28 letter to Jeffrey Kang, director of HCFA's Office of Clinical Standards and Quality. The lack of such an agreement "creates a tenuous foundation for the entire coverage decision-making process," according to the group, which plans to discuss the matter further with Kang during a May 12 conference call
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