CMS proposes coverage update for blood-derived products


CMS is proposing coverage changes for certain blood-derived products and treatments. 

The agency Dec. 21 proposed covering autologous platelet-rich plasma for the treatment of chronic nonhealing diabetic wounds.

Platelet-rich plasma is only covered with evidence development pathway for the treatment of the wounds when beneficiaries are enrolled in a clinical study.

The coverage policy update would eliminate the requirement that these treatments only be paid for through the pathway when beneficiaries are enrolled in a clinical study. The proposal also states that coverage decisions on the treatment would be determined by local Medicare administrative contractors. 

"Today's proposed decision for platelet-rich plasma demonstrates CMS’ ironclad commitment to update our coverage policies so they reflect the most current medical evidence," said CMS Administrator Seema Verma. "America’s seniors deserve constant vigilance on the part of Medicare to ensure the best treatment options are available. Under President Trump’s leadership, CMS has given them exactly that."

Stakeholders have 30 days to comment on the proposed national coverage change. 

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