Monitor, review and take action by commenting and meeting with CMS staff on Medicare coverage, coding and payment issues that impact wound care procedures and technologies. These include but are not limited to the following:
- Physician fee schedule
- Outpatient Prospective Payment System
- A/B MAC and DMEMAC local coverage determination policies on wound care
Monitor government and other key organizations actions to ensure that wound care procedures, technologies and payment are adequately and accurately included in key government agencies shaping health care reform. These include but are not limited to:
- Center for Medicare and Medicaid Services (including Innovation Center)
- Patient Centered Outcomes Research Institute (PCORI)
- National Quality Forum (NQF)
- Agency for Health Care Research and Quality (AHRQ)
- Medicare Payment Advisory Commission (MedPAC)
Continue to work with the FDA on issues impacting wound care including but not limited to: classification of wound dressings combined with drugs, real-world evidence and wound care guidance documents (e.g. 2006 “Guidance for Industry – Chronic Cutaneous Ulcer and Burn Wounds Developing Products for Wounds”).
Educate CMS and its contractors A/B MACs and DME MACs on coding, coverage and payment of wound care technologies.
Work with Centers for Medicare and Medicaid Services and other organizations to ensure wound care is discussed and included in alternative payment models and payment reform.
Educate Alliance members on new Medicare payment reform initiatives (Alternative Payment Models [APMs] and Merit-based Incentive Payment System [MIPS]).
Monitor and proactively support legislative initiatives impacting wound care endorsed by the Alliance.
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