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AdvaMed Medicare Policy Meeting In Brief

This article was originally published in The Gray Sheet

Executive Summary

New tech add-on application status: Medtronic InFuse bone graft/LT-Cage lumbar tapered fusion system's acceptance for add-on payment under the hospital inpatient prospective payment system will depend on the content of "data [gathered] between the proposed rule and final, to assess whether it meets the payment adequacy test," Stephen Philips, CMS division of acute care deputy director, reported at the AdvaMed seminar on Medicare policy in Baltimore May 8. The firm was denied a new tech add-on payment last year due to insufficient data (1"The Gray Sheet" July 6, 2002, p. 9). The inpatient proposed rule is slated for May 21 release....Guilford Gliadel wafer: New tech add-on payment likely will be denied for use in patients undergoing surgery for newly diagnosed malignant glioma, an indication approved in February, because the product was originally approved in 1996. Therefore, receiving a new ICD-9 code "does not start the clock ticking anew as far as [being classified as a] new technology," CMS' Philips explained May 8...
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