CMS Releases ‘Innovators’ Guide’

The Centers for Medicare and Medicaid Services (CMS) announced the release of the Innovators' Guide to Navigating CMS, a guide to Medicare coverage, coding, and payment. According to a CMS press release, the guide was created so that "Medicare beneficiaries and their healthcare providers may be able to take advantage of new advances in healthcare more quickly...."

Released on August 25, the Innovator's Guide includes sections on national and local coverage determination, Healthcare Common Procedure Coding System (HCPCS) and HCPCS coding guidance, and payment. According to CMS, "This is the first time [this information] has been presented in a single resource document."

"Our aim is to provide the highest quality healthcare to people with Medicare and the tools to help them get that care," said Kerry Weems, acting administrator at CMS. "We now have the coverage, coding, and payment requirements that developers and technology innovators need in one place. This will help them to better navigate Medicare requirements by explaining how to make their products available to Medicare beneficiaries."

In some cases, where a technological advance is groundbreaking, CMS noted that it may need to make explicit coverage, coding, or payment changes to ensure the coverage of reasonable and necessary new treatment options and the availability of medically appropriate technologies to its beneficiaries.

The guide was developed by the CMS Council for Technology and Innovation (CTI), a group charged with "streamlining and creating a more transparent process to get new technologies to patients more quickly," CMS said. CTI is composed of senior CMS staffand clinicians, and was established by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

For more information about CTI or to download a copy of the guide, visit: www.cms.hhs.gov/CouncilonTechInnov/