tci Part B Insider - 2011 Issue 25

In other news

You'll no longer have to wait for case-by-case determinations on whether your MAC will cover Provenge® for your seriously ill prostate cancer patients. CMS has issued a final coverage decision indicating that it will cover cellular immunotherapy, or sipuleucel-T (brand name Provenge®) effective immediately.CMS will cover Provenge® for FDA-approved uses including treating asymptomatic or minimally symptomatic metastatic castrate resistant prostate cancer. Previously, the treatment was covered only on a case-by-case basis by local contractors.Ever since CMS introduced its PQRS program, many practices have told CMS that they've faced difficulty understanding the intricacies of the system, with...

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