Submitted Comments
June 29, 2021
The Alliance submitted a letter to the National Correct Coding Initiative (NCCI) contractor requesting the elimination of the NCCI edit for Total Contact Casting, Multi-layer Compression, as well as Unna Boot paste casts for both the Physician and the Hospital Outpatient Payment areas. We voiced concerns that the edits are inconsistent with peer-reviewed literature and do not allow the accurate identification and allocation of resources for the clinical procedures provided to deliver the most effective clinical approaches for treatment of diabetic foot ulcers and venous ulcers. We asked that these changes be implemented as soon as the October 1, 2021 update of the NCCI edits. The Alliance letter included a clinical review of the published literature on these procedures and a summary of the existing evidence to support the elimination of these edits.
June 15, 2021
The Alliance submitted comments to CMS' CY 2022 Hospital Inpatient Prospective Payment System (IPPS) supporting adoption of wound care related quality measures and specifically advocating for inclusion of the Global Malnutrition Composite Score, NQF #3592.
April 16, 2021
The Alliance submited comments to CMS' Interim Final Rule regarding Medicare Coverage of Innovative Technology (MCIT) and the definition of “Reasonable and Necessary.” The Alliance encouraged CMS to move forward with select portions of the rule without additional delay, and provided feedback to specific questions posed by the Agency. However, the Alliance also reiterated its concern that the MCIT rule and the rule addressing the new definition of “reasonable and necessary” are two very distinct and separate topics of focus that should never have been issued together.
April 13, 2021
The Alliance submitted a letter to the National Quality Forum's Prevention and Population Health Endorsement Committee in support of the inclusion of MUC20-0032, the Global Malnutrition Composite Score, in CMS' Hospital Inpatient Quality Reporting (IQR) program. This letter is a follow-up to our initial January 2021 letter endorsing the composite measure to continue advocacy to move the adoption process forward.
March 23, 2021
Over the past four years, CMS has placed the issue of reforming the CTP payment methodology in the Hospital Outpatient Prospective Payment System (OPPS) proposed/final rules, soliciting feedback on Episodic Payment, Single APC, and Comprehensive APC. In March, the Alliance developed and proactively submitted to CMS its recommendations regarding CTP payment methodology for the Agency to consider as it begins development of proposed rules for CY 2022. In summary, the Alliance encouraged CMS to propose a CTP/skin substitute payment methodology for CY 2022 implementation that collapses the “high cost” and “low cost” products, allows separate payment for the add-on codes, and tracks the base codes and add-on codes to unique APC Groups which are updated annually. See detailed recommendation in CMS letter, below.
March 15, 2021
When Noridian issued a draft wound care local coverage determination (LCD) in February, the Alliance quickly mobilized to provide feedback and recommendations to shape the final policy. Ensuring that this draft was correct clinically is important to Alliance members since it could be used by other AB MACs in the future. The draft policy as issued was well-rounded and reflected some of the feedback previously provided by the Alliance to Noridian. However, the policy also included a significant number of areas with inaccurate information, outdated terminology, and, in several cases, inconsistent or conflicting language. The Alliance convened a workgroup to bring together the broad expertise of our membership to develop extensive comments to both the draft LCD and its accompanying policy article (LCA).
January 20, 2021
The Alliance submitted comments to CMS in support of the National Coverage Decision (NCD) for Autologous Blood-Derived Products for Chronic Non- Healing Wounds. The Alliance applauded Medicare’s decision to provide coverage for the use of autologous platelet-rich plasma (PRP) for patients with chronic non-healing wounds, but pointed to certain language in the policy that was not clinically accurate and suggested modifications.
January 19, 2021
The Alliance submitted comments to the National Quality Forum's Measure Applications Partnership (MAP) Coordinating Committee to support inclusion of the Global Malnutrition Composite Score (MUC20-0032) in the Hospital Inpatient Quality Reporting program. This can "improve patient care outcomes through standardized identification and treatment of malnutrition." See the Alliance's full letter to the NQF below.
January 4, 2021
As part of the Alliance's ongoing advocacy to make the HCPCS coding process more transparent, understandable and predictable, the Alliance submitted comments and recommendations to CMS' Medicare CY 2021 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Policy Issues and Healthcare Common Procedure Coding System (HCPCS) Level II Proposed Rule. The comments supported the ongoing advocacy work of the Alliance for HCPCS II Coding Reform (of which the Alliance is a member) and focused on code cycles, application re-submissions and other key areas to increase the speed of new products receiving codes so that patients have access to the latest products more quickly.
December 22, 2020
The Alliance delivered oral comments at the Dec. 22, 2020 HCPCS Public Meeting for Non-Drugs and Non-Biologicals to support the need for the CMS HCPCS Workgroup to create a product specific Q code for Restrata and any other product who meets the newly created skin substitute definition that now includes synthetic products.
