CMS evidence guidance
This article was originally published in The Gray Sheet
Executive Summary
Draft document focusing on clinical effectiveness thresholds needed to meet agency's standard for "reasonable and necessary" should "be out sometime this year" and will "describe what type of evidence we really are looking for," Ronald Dei Cas, MD, medical officer, Coverage & Analysis Group, states at the Fourth National Forum on Biomedical Imaging in Oncology in Bethesda, Md. Feb. 6. This spring, CMS also hopes to release its final reg on the beneficiary appeals process, allowing Medicare beneficiaries to challenge coverage policies directly. CMS' proposed rule was criticized by the House Ways & Means Committee and AdvaMed (1"The Gray Sheet" Oct. 28, 2002, p. 13)...
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