Call to Action: Local Non-Coverage Draft Policy for Artificial Discs
BY KELLI HALLAS, OCTOBER 3, 2005
By Kelli Hallas
Vice President of Field Reimbursement Services
Emerson Consultants, Inc.
[Editor's note: We welcome consultant Kelli Hallas as a guest blogger. See a profile of Emerson Consultants, Inc. here.]
Last month CMS issued a National draft non-coverage decision for artificial discs. Over 130 groups including physicians, industry representatives, and patients responded to this proposed policy and urged CMS not to issue this decision until the appropriate data could be colleted.
Now however, there is another issue of equal importance; the first draft policy for non-coverage has been posted at the local contractor level from Noridian Administrative Services, LLC. Noridian is the Part B Medicare carrier with jurisdiction over the following states: CO, ND, SD, WY, AK, AZ, HI, NV, OR, and WA.
Medicare coverage decisions can be made at either the National or Local level. A National Coverage Decision (NCD) is binding on all Medicare contractors; they are required to follow it. If an NCD does not exist, a Local Coverage Decision (LCD) can be made by individual local Medicare contractors.
A Call to Action is necessary for all those impacted by this decision to be assured that artificial discs currently available, as well as those currently under investigation, are a viable option for Medicare beneficiaries within the Noridian jurisdiction. The open comment period for this draft policy is through 12/15/2005. Send your comments electronically to policyb.drafts@noridian.com. Hard copy submissions can be sent to:
Noridian Administrative Services, LLC Contract Medical Director
Policy Development-Medicare Part B draft
901 40th Street South Fargo, ND 58103-2146
For more information pertaining to Noridian Administrative Services visit www.noridianmedicare.com. To obtain a complete copy of this draft non-coverage policy or to discuss this process further, you may contact Barb Peterson or Kelli Hallas at Emerson Consultants at (952) 374-6000.
Thank you for your attention to this urgent matter. Please forward this information on to your colleagues in the impacted states so they have an opportunity to submit comments as well.
