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CMS Accelerates Innovation and Promotes Patient Access to Medical Technology

As part of broader efforts to modernize the Medicare program and bring the latest technologies and innovations to Medicare beneficiaries, the Centers for Medicare & Medicaid Services (CMS) announced changes to the way contractors decide which technologies are covered by publishing a revision to Medicare’s Program Integrity Manual.

Medicare Administrative Contractors (MACs) determine which healthcare items and services meet requirements for Medicare coverage — taking into account local variations in the practice of medicine — through “local coverage determinations” or LCDs. LCDs are issued when national determinations do not exist, or when MACs need to further define a national determination. The updated manual responds to Congress’ requirement in the 21st Century Cures Act for more transparency in the LCD process and aims to ensure an open LCD process that meets patients’ needs. The changes will clarify and simplify the process, helping to ensure that companies can get therapies and devices to patients more efficiently.

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