WE DID IT!!
Thanks to collaborative and tenacious advocacy from the wound care community, the local coverage determinations (LCDs) and local coverage articles (LCAs) that would have dramatically restricted use and access to CTPs starting Oct. 1st have now been WITHDRAWN. 

SEE NEWS RELEASE

SAMPLE LETTER THAT PATIENTS CAN CUSTOMIZE AND SEND TO MACS and CMS

Email Outline: What Should Your Email Include?
Below is a suggested email outline to adapt and customize in your own voice to alert Medicare policymakers about the impact of the new diabetic foot ulcer/venous leg ulcer coverage policy to your care. (See issue overview.)

1. Intro: Who you are, what you are receiving treatment for (diabetic foot ulcer / venous leg ulcer), and where you are receiving care (institution, city, state).
2. Summary of concerns about the impact to your care
3. Request to delay implementation and/or addition of a grandfather clause which would allow for your continued care as prescribed by your medical team.
4. Send your email now so that Medicare policymakers have time to consider your request ahead of the Oct. 1 policy implementation date. 

Sample Email To Edit And Customize In Your Own Voice:

Dear [MAC name] medical director [NAME] - 

Section 1: Introduction
Example: “My name is [. ] and I am receiving treatment for my [diabetic foot ulcer or venous leg ulcer]. from [name of provider, name of clinic/institution, city, state]. My wound management plan currently includes treatment with a CTP/skin substitute and your new coverage policy “Skin Substitute Grafts/Cellular and or Tissue-Based Products for the Treatment of Diabetic Foot Ulcers and Venous Leg Ulcers” is going to affect me. I will be in the middle of my treatment when your policy’s Oct. 1st implementation date starts, and I am genuinely concerned and frustrated that my wound healing is going to be interrupted as a result.”

Section 2: Summary of Impacts [ASK YOUR CLINICIAN WHICH SCENARIO APPLIES TO YOUR CARE]

Scenario A: The CTP/skin substitute product you are being treated with is still “covered" under the new policy but you have already received 4 treatment applications, so additional applications after Oct. 1 will not covered by your insurance, even if your treatment plan had included more.
Example: “I understand that under your new policy, my doctor will not be able to continue with my established plan of care past Oct. 1st if I have already received 4 CTP applications. I am frustrated that my medical team and I cannot follow the treatment plan which has demonstrated progress towards wound healing. The risks of discontinued or interrupted treatment can include hospitalization and even amputation. This is terrifying to me! And it is so frustrating because it is so avoidable! I should be able to continue to completion the treatment protocol put in place with my healthcare provider prior to your policy’s arbitrary implementation date. I urge you to permit me to do so. It is a matter of life and limb.”

Scenario B: You are currently mid-treatment with product that was moved to the policy’s non-covered list, but your clinician will need to stop using that product, regardless of wound healing progress, to comply with the new coverage limitations starting on the policy’s Oct. 1st implementation date.
Example:  “I will be in the middle of a 12-week plan of care when your Oct. 1st implementation date goes into effect. Under the new policy, my wound treatment plan will no longer be covered by Medicare. My wound healing progress will be disrupted as a result! I’m frustrated that my health care provider and I cannot follow the treatment plan we’d planned to achieve wound healing, and insufficient time to modify my care plan was provided. The risks of discontinued or interrupted treatment for my [diabetic foot ulcer / venous leg ulcer] can include hospitalization and even amputation. This is terrifying to me! It is doubly frustrating because it is avoidable! I should be able to continue to completion the treatment protocol put in place with my healthcare provider prior to your policy’s arbitrary implementation date. I urge you to permit me to do so. It is a matter of life and limb.”

Section 3: Request for Implementation Delay 
Example: “I ask that you delay the implementation of this policy so that I - and others like me currently receiving wound care - can continue our current plan of care and complete the full course of treatment with CTPs/skin substitutes as determined appropriate by my medical team. At very least, I ask that you put in place a “grandfather clause” so that people like me who are mid-treatment can finish the course of treatment that was set, without interruption.”

If you have specific questions about my wound healing plan of care, please contact me or my healthcare provider.

Thank you for your consideration,
Your name
Your address & contact info

DOWNLOAD TEMPLATE AS WORD DOCUMENT TO CUSTOMIZE
See a patient's recently submitted email


Who To Send The Email To: 

• If you are a patient receiving care in Arkansas, Colorado, Delaware, Louisiana, Maryland (Montgomery & Prince George’s counties), Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, Texas, Virginia (Arlington & Fairfax counties, Alexandria), and/or Washington DC
  • Send email to Novitas Medical Director, Dr. Leslie Stevens at  This email address is being protected from spambots. You need JavaScript enabled to view it. ­­­with a CC to This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Subject Line: Please Delay Implementation of Novitas CTP/skin substitute LCD L35041 & LCA A54117

•  If you are a patient receiving care in Florida, Puerto Rico, and/or the U.S. Virgin Islands:
  • Send email to First Coast Medical Director Dr. Alicia Campbell at  This email address is being protected from spambots. You need JavaScript enabled to view it. with a CC to This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Subject Line: Please Delay Implementation of FCSO CTP/skin substitute LCD L36377 & LCA A57680
    
    
    • If you are a patient receiving care in Kentucky and/or Ohio:
      • Send email to CGS Medical Director Dr. Meredith Loveless at This email address is being protected from spambots. You need JavaScript enabled to view it. with a CC to This email address is being protected from spambots. You need JavaScript enabled to view it. and This email address is being protected from spambots. You need JavaScript enabled to view it.     
      • Subject Line: Please Delay Implementation of CGS CTP/skin substitute LCD L36690 & LCA A56696  

Remember, send your email by late-September (ideally by Mon., Sept. 25) so that the medical directors have time to consider your request in advance of the policy's Oct. 1 implementation date.

After sending an email to your MAC medical director, please also consider forwarding a copy of it to the Alliance of Wound Care Stakeholders at This email address is being protected from spambots. You need JavaScript enabled to view it.. As lead advocates on this issue, we'd like to be able to have a selection of submitted emails to reference in conversations we are scheduling with Medicare staff and leadership.