Dexcom and Abbott both commended a change to Medicare policies that benefits continuous glucose monitor (CGM) users. Last month, the Centers for Medicare & Medicaid Services (CMS) published a final local coverage determination (LCD) expanding coverage for CGMs. The ruling has now gone into effect. CMS first published the LCD modifying coverage criteria for CGMs in […]
Medicare
DOJ charges former Stimwave CEO over alleged non-functioning neuromod implant
The U.S. Justice Dept. (DOJ) announced today that it filed a two-count indictment charging former Stimwave CEO Laura Perryman, claiming a scheme around the company’s neuromodulation technology. Damian Williams, the United States Attorney for the Southern District of New York, Michael J. Driscoll, the Assistant Director in Charge of the New York Field Office of […]
Expanded Medicare coverage for CGM to go into effect next month
The Centers for Medicare & Medicaid Services today published a final local coverage determination (LCD) expanding coverage for CGMs. New, expanded coverage of continuous glucose monitors (CGMs) under Medicare go into effect in April. CMS first published the LCD modifying coverage criteria for CGMs in October. The modification includes people with diabetes who receive insulin […]
Medicare to cover Dexcom G7 when it launches this week
Dexcom (Nasdaq:DXCM) announced today that Medicare offers coverage for its beneficiaries using the next-generation G7 CGM. The company announced the coming U.S. launch for G7 in a Super Bowl Commercial with musician Nick Jonas last night. It’s slated to roll out on Friday, Feb. 17. San Diego-based Dexcom met the category requirements for therapeutic continuous […]
BioTelemetry, CardioNet to pay nearly $45M to resolve False Claims Act violation allegations
BioTelemetry and its CardioNet subsidiary agreed to pay $44.875 million to resolve False Claims Act violation allegations. Both companies now belong to Philips after it acquired BioTelemetry for $2.8 billion last year. The U.S. Department of Justice alleged that the companies knowingly submitted false claims surrounding heart monitoring tests. DOJ claims the companies submitted claims […]
iRhythm comments on new national pricing from CMS
iRhythm Technologies (Nasdaq:IRTC) today commented on a recent announcement from the Centers for Medicare and Medicaid Services (CMS). CMS issued its Medicare Physician Fee Schedule (MPFS) Final Rule for Calendar Year 2023. The final rule covers payment policies, payment rates and other provisions for services furnished on or after Jan. 1, 2023. The rule includes […]
Analysts: Abbott, Dexcom to benefit from proposed CMS decision on CGMs
Analysts see a new proposed local coverage determination (LCD) from CMS as a potential boost for Dexcom (Nasdaq:DXCM) and Abbott (NYSE:ABT). The Centers for Medicare and Medicaid Services (CMS) yesterday published the LCD modifying coverage criteria for continuous glucose monitors (CGMs). The modification includes people with diabetes who receive insulin treatment or have a history […]
New CMS codes for angina detection, tracking benefit Neovasc
Neovasc (Nasdaq:NVCN) announced today the Centers for Medicare and Medicaid Services (CMS) developed favorable new codes. The new codes cover the diagnosis and tracking of refractory angina. Neovasc develops the Reducer system for reducing angina symptoms in those with refractory angina. According to a news release, the codes will be utilized in the current, 10th […]
Philips, DOJ settle for $24.8M over Respironics kickback allegations
Philips (NYSE:PHG) today agreed to pay more than $24 million to resolve False Claims Act allegations revolving around kickbacks. The U.S. Department of Justice (DOJ) alleged that Philips RS North America (formerly Respironics) misled federal healthcare programs by paying kickbacks to durable medical equipment (DME) suppliers. Affected programs included Medicare, Medicaid and TRICARE, the healthcare […]
Nevro wins multiple coverage options for spinal cord stimulation
Nevro (NYSE:NVRO) today announced positive updates to multiple spinal cord stimulation (SCS) coverage policies. Aetna’s new SCS policy explicitly covers PDN (painful diabetic neuropathy), effective Aug. 29, 2022. Aetna’s health plan covers approximately 22 million commercial lives. Novitas and First Coast, Medicare Administrative Contractors (MACs) that represent 12 states, also provided a positive update. They […]
CMS will limit coverage of Aduhelm to people in clinical trials
The Centers for Medicare & Medicaid Services (CMS) released a national policy regarding coverage for Aduhelm (aducanumab). Controversy has surrounded the Alzheimer’s drug Aduhelm from Biogen (NSDQ:BIIB) and Eisai (TYO:4523) since the FDA’s fast track approval last year. Three members of an FDA advisory committee resigned after the approval. About a week later, nonprofit watchdog group Public Citizen called for high-profile resignations of […]
