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Dr. Samuel R. Nussbaum, former Chief Medical Officer of Anthem, speaks with Deanna Eaves, Coalition co-chair and Marcia Nusgart before presenting at the Coalition’s 2016 strategic planning meeting; Coalition of Wound Care Manufacturer members at its 2016 strategic planning meeting; Amy Bassano, Director of the Patient Care Models Group in CMS’ Center for Medicare & Medicaid Innovation (CMMI) with Coalition co-chairs Deanna Eaves and Randall Carson and Executive Director Marcia Nusgart at the Coalition’s 2016 meeting; Patient Centered Outcome Research Institute (PCORI) staff Greg Martin at 2015 Coalition meeting; CMS Director Dr. James Rollins at 2015 Coalition meeting.

Workplan

The Coalition includes in its workplan not only general Medicare and Medicaid coding, coverage and reimbursement issues included in all the Coalitions' workplan, but also specific wound care issues. The workplans are also fluid and may be changed throughout the year to include new issues that impact manufacturers and their customers.

2017 Coalition Workplan

The Coalition functions as the respected and credible unified voice of wound care manufacturers to private/public payers and government entities to ensure patient access to wound care products and services. We accomplish this by:

 

  • Ensuring the Coalition’s voice is heard when advocating for accurate and adequate coverage, coding and payment for wound care products and services by performing these activities:
    • Submitting comments on draft LCDs impacting wound care to the DMEMAC and A/B MACs (including but not limited to: negative pressure wound therapy, cellular and/or tissue based products for wounds, surgical dressings, debridement)
    • Reviewing CMS and FDA proposed regulations (Outpatient Prospective Payment System, Physician Fee Schedule, Durable Medical Equipment Prosthetic and Orthotic Supplies, etc.) for assessment of wound care industry impact and comment as appropriate
    • Meeting with CMS, FDA or other relevant agencies and/or Congressional offices as needed to educate agencies on the Coalition’s behalf
    • Voicing concerns regarding process issues with all governmental agencies (including PDAC, DME MAC and FDA) by attending meetings and submitting comments
  • Collaborate with and support the Alliance of Wound Care Stakeholders in addressing wound care issues such as: 
    • Medicare payment reform initiatives such as Merit-based Incentive Payments Systems and Alternative Payment Methods
    • Physician quality issues
    • Appropriate coverage, coding and payment of wound care products and services
  • Collaborate with and support the Alliance of HCPCS Coding Reform
  • Providing members with access to key policy decision makers and educating them on timely and important issues through in-person seminars.

 

©2013 Nusgart Consulting LLC