CMS Is Listening

CMS Convenes Refinement Panel
Thanks to all of you who contacted CMS and your legislators. On September 26th, CMS convened a refinement panel that considered the DXA work RVU because public comment demonstrated significant disagreement with their proposal.   AACE and ACRheumatology were invited to participate on this panel, and Drs. Andrew Laster and Sanford Baim, representing ACRheumatology, presented an in-depth case, including data from the ISCD survey that 381 of you completed this summer. (Click here to read their presentations.)  Dr. Nelson Watts, representing AACE fully supported Drs. Laster and Baim.  After the presentation, panel members voted on an appropriate RVU for DXA.  Voting is done anonymously, and the results of the vote are not public. CMS may take into consideration the refinement panel’s findings in making a final determination on the work RVU.

ISCD Meets with CMS Administrator McClellan 

On Thursday, October 5, ISCD public policy representatives, along with a number of women’s health organizations, were fortunate to meet for a full hour with Administrator McClellan, Acting Administrator-Designate, Leslie Norwalk, and seven senior Medicare staff.  The meeting was generated by concern over the drastic proposed cuts to osteoporosis and breast cancer screening and diagnostic services, at the same time that Dr. McClellan is emphasizing disease prevention.

Representatives from a number of women's health organizations and two clinicians were asked to present information regarding the proposed cuts.   Only two clinicians were invited to make brief presentations, including Dr. Andrew Laster from ISCD.  Dr. Andrew Laster presented detailed information about the profound effect these regulatory cuts will have on access to high quality bone density screening.He raised a number of problems in the way Medicare had computed the cuts to DXA and VFA.  He made the case for calculating the value of screening procedures in a way that will ensure widespread patient access.

Dr. McClellan’s articulated his vision of moving CMS closer to an organization that values quality screening and understands the role it plays in women's health.  He urged organizations present to be partners in reaching and educating women about the importance of being screened.   

Since the comment period on the proposed cuts to osteoporosis screening was still open at the time of the meeting, Medicare officials were constrained in what they could say.  However, they seemed to listen closely and asked questions. We were encouraged by their receptivity.

Upcoming Meeting with CMS Staff Regarding DXA/VFA

Importantly, ISCD was able to obtain an additional meeting with CMS staff to discuss DXA and VFA reimbursement issues. At this meeting, be held in Baltimore on October 16th, Drs. Laster and Baim will present data, including the clinical society survey, supporting preservation of DXA and VFA reimbursement.   Representatives from AACE and the National Osteoporosis Foundation will also participate in this meeting.  

ISCD Files Comments on CMS 1321-P on October 10th

Separate from the earlier proposed rule (CMS 1512-PN), CMS is also considering this rule that will address provisions of the Deficit Reduction Act of 2005, and proposed changes to Medicare part B payment policy.  This rule proposes 1) to further reduce reimbursement for DXA by decreasing the practices expense RVU.  2)  introduces the important concept of quality and standardization in axial DXA testing and reporting, and 3) lowers the cut point for DXA testing in patients on glucocorticoids from less than or equal to 7.5 mg for at least three months, to less than or equal to 5 mg a day for at least three months. 

ISCD submitted comments on CMS 1321-P and reiterated and expanded upon our earlier concerns about DXA and VFA reimbursement cuts that ISCD had submitted in August . Click here to read our testimony.

Finally, thank you again for all of your hard work in on this issue., by participating in the clinician’s DXA survey and recruiting your members to personally provide CMS with their invaluable commentary on these cuts in central DXA and VFA reimbursement. It is clear that our concerted activity is making a difference.

Legislative Alerts

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Public Policy Issues page

Page Last Updated: 12/11/2010

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