The Centers for Medicare and Medicaid have opened a National Coverage Analysis looking to reconsider its National Coverage Determination for transcatheter aortic valve replacement procedures. Medicare’s NCD for TAVR was established in 2012 with strict criteria for reimbursement and procedure performance that limited TAVR to high-volume hospitals and medical centers. Requirements in the 2012 decision […]
CMS administrator Verma calls on insurers, providers to give patients their data
For the millions covered by Medicare, accessing their healthcare data ought to be simple – after all, the data belongs to them, according to Centers for Medicare & Medicaid Services administrator Seema Verma. Earlier this year, CMS launched the latest version of the Blue Button initiative, a program designed to allow Medicare beneficiaries to collect […]
Jury convicts four in CMS-Deerfield insider trading case
A federal jury yesterday reportedly convicted a Centers for Medicare & Medicaid Services worker and three others of using inside information as the “secret sauce” in a $7 million insider trading scheme with a well-known healthcare hedge fund. Consultant David Blaszczak, founder of Precipio Health Strategies and the one-time colleague at CMS of Christopher Worrall, pleaded not […]
CMS approves expanded MRI coverage for CRM patients
The Centers for Medicare & Medicaid Services have finalized a plan that will cover magnetic resonance imaging scans for patients with implanted cardiac devices, including pacemakers, cardioverter defibrillators and cardiac resynchronization therapy devices, according to a MedPage Today report. The finalized decision, which was released in January, will allow Medicare patients with MR-conditional devices to […]
Feds: CMS insider’s ‘secret sauce’ drove NY hedge fund’s healthcare bets
Federal prosecutors yesterday reportedly accused a political consultant of using his contact at the Centers for Medicare & Medicaid Services as the “secret sauce” in a $7 million insider trading scheme with a well-known healthcare hedge fund. Consultant David Blaszczak, founder of Precipio Health Strategies and the one-time colleague at CMS of Christopher Worrall, pleaded […]
Medicare: Hospitals mishandled warranty credits for recalled cardiac devices
A number of US Hospitals have failed to appropriately pay Medicare for warranty credits received from cardiac device manufacturers for recalled devices, according to a new report from the Dept. of Health and Human Services Office of Inspector General. In the report, a total of 296 payments for recalled cardiac devices were reviewed, and all […]
Report: CMS nixes plans for pathway for expedited medical device coverage
The Centers for Medicare & Medicaid Services has canceled plans to create a new regulatory pathway that aimed to accelerate Medicare coverage for medical devices, according to a ModernHealthcare report. The federal agency reportedly withdrew the proposition, known as Excite, from review at the White House’s Office of Management and Budget this month, nine months after […]
CMS mulls expanded MRI coverage for CRM patients
The Centers for Medicare & Medicaid Services is thinking about extending coverage for magnetic resonance imaging scans to patients with cardiac rhythm management devices after reviewing studies showing that MRI scans are safe. If finalized the decision would allow Medicare patients with implanted MR-conditional devices such as pacemakers or defibrillators to have their MRI scans […]
Insulet lands Medicare Part D coverage for Omnipod insulin delivery system
The Centers for Medicare and Medicaid Services issued guidance today noting that Insulet‘s (NSDQ:PODD) Omnipod tubeless insulin delivery device can be covered by the Medicare Part D prescription drug program. The Billerica, Mass.-based company estimated that its latest reimbursement win extends access to the Omnipod system to 450,000 people with Type I diabetes across the U.S. […]
Abbott nabs CMS reimbursement for FreeStyle Libre continuous glucose monitor
Abbott (NYSE:ABT) said today that its FreeStyle Libre continuous glucose monitor is now available to Medicare patients, after the Centers for Medicare & Medicaid Services determined that the device can be classified as a therapeutic CGM. The FreeStyle Libre is designed to read glucose levels through a sensor worn on the back of a person’s upper […]
Report: Drugmakers may have ducked $1.3B in Medicaid rebates
Without calling out any drug companies by name, the U.S. Dept. of Health and Human Services’ Office of Inspector General revealed this week that 10 potentially misclassified drugs may have resulted in $1.3 billion in lost rebates to Medicaid between 2012 and 2016. The issue of ducking rebates came to the public’s attention earlier this […]
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