CMS to expedite acceptance of new products

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Sunday, October 10, 2004

October 11, 2004

BALTIMORE -  CMS is implementing a series of changes to the HCPCS coding process that should make it easier for manufacturers to move new technology to patients more quickly and easier for the public to follow CMS’s decision-making with regard to specific coding decisions.
In the next 18 months, CMS plans to phase in the following changes.
Coding requests at DME meetings. To let the public know what new coding changes are under consideration, CMS will begin addressing coding requests at the current public meetings related to DME. CMS will publish the agenda items in advance, including descriptions of the coding requests, the requestor, and the name of the product or service.
Reduction in Marketing Data for Non-drug items . The marketing requirement for durable medical equipment, orthotics and supplies will be reduced from 6 months to 3.
Appeals Process. Starting with the 2007 coding cycle, denied applicants will be allowed to appeal the decision and have an opportunity to have their application reconsidered during the same coding cycle.
Public Notice of Decisions. All preliminary decisions will be published on the CMS website prior to public meetings, to facilitate effective public discussion and comment.  Final decisions based on public comments, as well as decisions resulting from appeals, will be similarly published.
Revision of the HCPCS Code Application Form . The application format is being revised to be more streamlined, user-friendly, and to incorporate helpful suggestions received as a result of the stakeholder survey.
Consideration of national Medicaid program operating needs. CMS is working with State Medicaid Directors to establish a process to consider coding changes that may be needed based on national Medicaid program operating needs.
The number and complexity of coding applications submitted has increased dramatically over the past 10 years from 50 to nearly 300 applications per year, according to CMS.

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