The latest proposals were issued by National Government Services and CGS Administrators, which represent a combined 12 states. The companies have different public comment periods, with NGS’s running from Sept. 26 to Nov. 9 and CGS’s going from Oct. 30 to Dec. 14.
Minneapolis-based Inspire Medical said it expects the final LCDs to be published in early 2020, with four LCDs already published this year.
The company had two LCDs published August 26 by Medicare contractors Noridian Medicare and Palmetto GBA. Four days later, the company said Novitas Solutions and First Coast Service Options also issued LCD proposals (First Coast also cancelled its existing negative policy on Inspire therapy). Novitas and First Coast collectively represent 12 states and the District of Columbia.
Together, the six medicare administrative contractors represent patients in 44 states and the District of Columbia. The draft LCDs from NGS and CGS are consistent with those from Noridian, Palmetto, Novitas and First Coast. All state that for individuals with obstructive sleep apnea who are treated with hypoglossal nerve stimulation, evidence sufficiently determines that Inspire’s threapy results in a meaningful improvement in net health outcomes.
“With these two additional LCDs, Medicare patients in 44 states are expected to have access to Inspire therapy,” Inspire Medical president & CEO said in prepared remarks. “We look forward to the potential issuance of formal policies from NGS and CGS, and anticipate that the one remaining MAC will also soon issue a draft policy for Inspire therapy.”
Shares of INSP were down -1.4% at $61.75 per share in midday trading today.