CMS Ambiguous On Role Of Local Contractors In Coverage With Evidence Development
This article was originally published in The Gray Sheet
Executive Summary
Activities by Medicare contractors were among several matters that were addressed in CMS’ recent CED draft guidance that may not be fully clarified until the updated guidelines are put into practice, experts say.
You may also be interested in...
Local Coverage With Evidence Development Is Legit, CMS Says; But It May Be Rare
CMS issued its final guidance on the coverage-with-evidence-development program, two years following a draft. It is explicit that local Medicare contractors can employ CED in setting coverage policies in their jurisdictions, but it is not clear that the language will encourage significant use at the local level. The guidance also revises its approach on ending CED policies compared to what was stated in the 2012 draft guidance.
More Cohesive Coverage-With-Evidence Authority Needed, Lawmakers Told
Former CMS coverage chief Louis Jacques told House lawmakers that the agency’s authorities to implement coverage-with-evidence-development policies are fragmented, hindering application of the program.
Louis Jacques On Coverage, Evidence And IDEs
Former CMS coverage director Louis Jacques talks about the strong future ahead he envisions for the Medicare coverage-with-evidence-development program and new coverage policies that will be implemented for investigational device exemption trials.