CMS In Brief
This article was originally published in The Gray Sheet
Executive Summary
Coverage with evidence for stem cell transplants?: CMS proposes May 6 to allow coverage with evidence development for allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome, a group of diverse blood disorders in which the bone marrow does not produce enough healthy, functioning blood cells (1"The Gray Sheet" Nov. 30, 2009). The proposed coverage memo outlines criteria for prospective controlled clinical studies, including the need to address specified treatment outcomes and to adhere to strict standards of scientific integrity. CMS is taking comments through June 5 and plans a final rule by Aug. 4
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CMS In Brief
CMS expands coverage of PET for solid tumors: Agency finalizes its coverage reconsideration Aug. 4 on positron emission tomography for solid tumors and myeloma, easing its previous strict limit of one FDG PET study per patient during the initial treatment stages. While CMS will continue to nationally cover only one PET scan to determine the location and/or extent of a tumor for therapeutic purposes related to the initial treatment strategy, local Medicare contractors will now have discretion to determine whether to cover additional PET scans as needed during the initial treatment stage. CMS opened the reconsideration late last year at the request of several radiology and nuclear medicine professional societies (1"The Gray Sheet" Nov. 16, 2009)
CMS In Brief
CMS expands coverage of PET for solid tumors: Agency finalizes its coverage reconsideration Aug. 4 on positron emission tomography for solid tumors and myeloma, easing its previous strict limit of one FDG PET study per patient during the initial treatment stages. While CMS will continue to nationally cover only one PET scan to determine the location and/or extent of a tumor for therapeutic purposes related to the initial treatment strategy, local Medicare contractors will now have discretion to determine whether to cover additional PET scans as needed during the initial treatment stage. CMS opened the reconsideration late last year at the request of several radiology and nuclear medicine professional societies (1"The Gray Sheet" Nov. 16, 2009)
Groups Ask CMS To Clarify Local Contractor Role In PET Coverage
Five professional societies are offering to draft model local coverage policy for Medicare contractors considering when to pay for additional positron emission tomography scans used in radiation oncology treatment planning