tci Medicare Compliance & Reimbursement - 2003 Issue 22

Coverage: LOCAL COVERAGE POLICIES UNDER ATTACK

Confused by your Medicare contractor's local coverage policies? If the General Accounting Office gets its way, local policies will be abolished altogether and the Centers for Medicare & Medicaid Services would make all coverage decisions on a centralized, national basis. In "Medicare: Divided Authority for Policies on Coverage of Procedures and Devices Results in Inequities" (GAO-03-175), the watchdog agency argues that variations in local coverage essentially lead to unfair geographical biases. It's not clear, however, that the GAO's proposal is likely to get very far. CMS firmly opposes the idea of eliminating local policies, maintaining, among other things, that...

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