We possess expertise on both Medicare local and national coverage issues. We advise our clients on existing coverage policies and, if none exist, plan and execute a strategy to develop a new one.
For new or already-existing medical devices, durable medical equipment, biologicals, and drugs, we perform the following coverage activities:
- Assess whether the device or drug is included in an already existing coverage policy that meets the needs of the company or product or whether it needs a new one.
- If a new or revised coverage policy is needed, we work with our clients to determine the strategy, timeline, and the clinical evidence needed for inclusion in a local or national coverage policy. We help clients evaluate the local and national policies in place relevant to their product and can help identify and mobilize clinicians who could be invited to support and serve as advocates. We will also make you aware of obstacles that could arise in the process of obtaining appropriate coverage.
- We work with our clients to determine what policy their product will be included and the type of clinical evidence required to gain coverage within that policy.
- We work with our clients to ensure that the policy language is clinically accurate and reflects the correct utilization of their product.