Medicare Compliance & Reimbursement

Also, triple-threat drug combo will target nausea and vomiting.

Medicare expanded its coverage for cochlear implant devices to include patients with open-set recognition test scores of less than 40 percent correct, the Centers for Medicare and Medicaid Services announced.
 
Previously, CMS required test scores of 30 percent correct or less for coverage. Also, Medicare will cover the devices for patients with test scores between 40 and 60 percent if they participate in an approved clinical trial.

Separately, CMS will cover a third drug to prevent nausea and vomiting among at-risk chemotherapy patients. The additional coverage for aprepitant, also known as Emend, will allow physicians to prescribe a three-drug combination that may relieve symptoms more effectively than the two already-covered drugs. Physicians administer the three-drug combo before chemotherapy, followed by extra doses afterward.

Medicare will also cover off-label uses of four chemotherapy drugs in approved clinical trials. Providers can use oxaliplatin, irinotecan, cetuximab and bevacizumab for non-Food and Drug Administration-approved uses as long as the trials are sponsored by the National Cancer Institute and approved by CMS, according to Transmittal 512, issued March 28.