The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for the Center of Medicare & Medicaid Services (CMS) have released proposed local coverage determinations (LCDs) for external infusion pumps and knee orthoses.
In a July 24 announcement from CGS Administrators, the Jurisdiction B DME MAC, the contractors said the external infusion pump LCD proposes to expand coverage for blinatumomab, a medication to treat acute lymphoblastic leukemia in adults and in children age one month and older. The proposed LCD also recommends updating coverage criteria for infusion-based therapy to treat motor control symptoms in beneficiaries with Parkinson’s disease whose symptoms are not being adequately managed through non-infusion-based therapies.
The knee orthoses proposed LCD recommends changes to coverage criteria for knee orthoses “with single or double upright, adjustable flexion and extension joint, medial-lateral and rotation control, with varus/valgus adjustment for the management or treatment of ambulatory beneficiaries with pain or reduction in mobility and/or function due to medial or lateral tibiofemoral osteoarthritis.”
The DME MACs are holding virtual public meetings to hear stakeholder comments on the proposed LCDs. The knee orthoses meeting starts at 10 a.m. Eastern on Aug. 27; the external infusion pumps meeting starts at 12 noon Eastern time, also on Aug. 27. Registration is now open for both meetings.
