tci Medicare Compliance & Reimbursement - 2006 Issue 27

COVERAGE: CMS Wants More Evidence To Fast-Track Coverage Determinations

Get ready for extensive documentation demands.After the Centers for Medicare & Medicaid Services' (CMS) recent announcement that it is re-thinking its national coverage determination (NCD) on clinical research coverage, the agency is now revising its guidance for NCDs that demand extra patient data. But whether CMS' revised approach will speed up coverage decisions or bog providers down in additional paperwork is still up in the air."Collecting additional patient data as part of the coverage process, Coverage with Evidence Development (CED), generates data on the utilization and impact of the item or service evaluated in the NCD,"...

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