Knee Orthoses Policy Meetings Combined

The Centers for Medicare and Medicaid Services assigned to the Durable Medical Equipment Regional Carriers (DMERCs) the task of developing medical policies for the purpose of processing and reviewing Medicare claims for Durable Medical Equipment, Prostheses, Orthoses and Supplies (DMEPOS) and other selected items. The DMERCs have developed a draft local coverage determination (LCD) and policy article for Knee Orthoses.

We are soliciting comments from manufacturers, suppliers, physicians, and other professionals involved in the ordering, provision, or use of these items. We recommend that you send this draft medical policy to selected members of your organization for review and comment. If you disagree with any aspect of the policy, you should be very specific and, if possible, offer an alternative indication, guidelines, etc. You should provide a clinical rationale for your position. If comments relate to medical necessity criteria, you should include references from the published clinical literature (e.g., standard textbooks, peer-reviewed journals, etc.). We would also encourage a written response if you agree with the policy.

When comments on this policy have been received, they will be reviewed and revisions to the policy will be considered. The revised policy will be published in future DMERC Regional Bulletins and Supplier Manual updates, allowing for adequate notice, before the policy’s effective date.Please submit your comments to each DMERC medical director by mail at the addresses below no later than October 25, 2004. Comments may also be submitted via e-mail through each DMERC’s Web site. In addition, a public meeting will be held by each DMERC to receive comments. Information regarding this meeting may be obtained from each individual DMERC’s Web site.

Paul J. Hughes, M.D.
Medical Director, DMERC Region A
TriCenturion, LLC
7909 Parklane Road – Suite 190
Columbia, SC 29223
www.tricenturion.com

Adrian M. Oleck, M.D.
Medical Director, DMERC Region B
AdminaStar Federal
8115 Knue Road
Indianapolis, IN 46250
www.adminastar.com

Stacey V. Brennan, M.D.
Medical Director, DMERC Region C
Palmetto GBA
P.O. Box 100141 – MailStop AG-250
Columbia, SC 29223
www.palmettogba.com

Robert D. Hoover, Jr., M.D., M.P.H.
Medical Director, DMERC Region D
CIGNA Healthcare-Medicare Administration
2 Vantage Way
Nashville, TN 37228
www.cignamedicare.com

Thank you for your participation in our policy development process.

A public meeting will be held by the Region A DMERC PSC for the purpose of receiving comments from interested parties on a recently released draft Local Coverage Determination.

The comment period extends from September 10, 2004 through October 25, 2004.

The policy is: Knee Orthosis

The meeting will be held on November 2, 2004 (Tuesday) from 1:00 – 3:00 P.M., Conference Rooms F & G at:

DMERC A PSC offices
Tricenturion
7909 Parklane Road – Suite 190
Columbia, SC 29223

Anyone wishing to attend and present at this meeting must register no later than Monday October 25, 2004, with Ms. Connie Hawkins (803) 264-7780. Each speaker will be allowed from 10 – 15 minutes, depending on the number of registered presenters.

Should you desire to participate in this forum but are unable to attend in person contact Ms. Hawkins for arrangements. All comment materials must be delivered in writing at the time of the meeting. These written materials will constitute the official record of each presentation. The next Draft LCD Open Meeting will be held on Tuesday, October 19, 2004, from 1:00 PM – 3:00 PM, in the Board Room at:

AdminaStar Federal
8115 Knue Road
Indianapolis, IN 46250
for discussion of the following draft policy: Draft Policy Name Knee Orthoses

Requests to Present Information at the Draft LCD Open Meeting

Interested parties who wish to make presentations at this meeting must submit a written request that includes the following items:

  • Name
  • Address
  • Telephone Number
  • E-mail Address
  • Name and address of the organization represented (If Applicable)
  • Brief Description of the Information Planned for Presentation

Requests must be received by October 8, 2004 to:

Adrian Oleck, MD
Region B DMERC Medical Director
AdminaStar Federal
8115 Knue Rd. – Mail Point AF10
Indianapolis, IN 46250

All requests will be acknowledged by either confirming or denying the request to present at the meeting. All members of the public are invited to attend the open meeting as observers. If a person is physically unable to attend the meeting but is interested in teleconferencing into the meeting, please send e-mail to: draft_lmrp_comments_DMERC@anthem.com. Approximately seven (7) days prior to the meeting, teleconference, parties will be notified of the telephone number and access number to the Draft LCD Open Meeting.

Comments on Draft Policies

All members of the public are invited to offer comment on this draft policy via e-mail or by the U.S. Postal Service. The formal comment period in which to submit comments for this draft policy is September 10, 2004 through October 25, 2004. Comments may be sent via e-mail todraft comments, or by hardcopy mail to the address above.

Public Meeting for Draft DMERC Local Coverage Determination – Knee Orthosis

A public meeting will be held by the Region C DMERC for the purpose of receiving comments from interested parties on a recently released draft Local Coverage Determination. The comment period extends from September 10, 2004 through October 25, 2004. The policy is: Knee Orthosis

The meeting will be held on November 2, 2004 (Tuesday) from 1:00 – 3:00 P.M., Conference Rooms F & G at:

DMERC A PSC offices
Tricenturion
7909 Parklane Road – Suite 190
Columbia, SC 29223

Anyone wishing to attend and present at this meeting must register no later than Monday October 25, 2004, with Ms. Gwen Backman (803) 763-7492. Each speaker will be allowed from 10 – 15 minutes, depending on the number of registered presenters.

Should you desire to participate in this forum but are unable to attend in person contact Ms. Gwen Backman for arrangements. All comment materials must be delivered in writing at the time of the meeting. These written materials will constitute the official record of each presentation. A public meeting will be held for the purpose of soliciting comments on the following new draft medical policy: Knee Orthoses

When: Wednesday, October 13, 2004
Time: 1:00 – 3:00 PM (CDT)
Where: Centers for Medicare and Medicaid Services

Region VII Regional Office
Pioneer Room #260
601 East 12th Street
Kansas City , Missouri

This meeting is being held in a federal office building and security screening is required. Attendees are encouraged to allow enough time for security screening procedures. Picture identification is mandatory. Interested parties who cannot physically attend the meeting may participate via teleconference by dialing toll-free 866.495.8274 and entering conference code 601008.

Comments should be limited to scientific, evidence-based information and professional consensus opinions. If possible, offer alternative indications, guidelines or coverage criteria. Information received at this meeting will be considered with the written comments submitted during the comment period, which officially ends on October 25, 2004.

Persons interested in speaking must submit their request, in writing or by phone, by Friday, October 8, 2004. Time allotments will depend on the number of registered presenters; however, regardless of the number registered, times will not exceed 20 minutes per speaker. Written copies or transcripts of presentation material must be provided to the Medical Director. Speakers may provide this material at the meeting site.

Thank you for participating in our policy development process.

Robert D. Hoover, Jr., M.D., M.P.H.
Medical Director, DMERC Region D
CIGNA HealthCare-Medicare Administration

2 Vantage Way
Nashville, TN 37228
615.782.4500 ext. 28812

  • Standard Post
  • Written by NAAOP in Update