Update on Medicare Coverage Decision for Stem Cell Transplant in Myelofibrosis

The Centers for Medicare & Medicaid Services’ Coverage and Analysis Group released a proposed decision memo Thursday on modifications to the National Coverage Determination for allogeneic Stem Cell Transplant. CMS has proposed to expand coverage through Coverage with Evidence Development (CED) for allogeneic HCT to include myelofibrosis, multiple myeloma and sickle cell disease.

Unfortunately, this does NOT mean that coverage for SCT for those with myelofibrosis is immediately available. There are three more stages to this process: 1) completion of the 30-day comment period, 2) completion of the 60-day final analysis period that CMS has after the close of the public comment period, 3) development, submission and approval of a study that meets guidelines set forth in the final decision. Coverage through Medicare will likely not be available until sometime in the first half 2016.

The National Marrow Donor Program is working on coordinating the study to the specifications needed by the CMS.

Public comments by people affected by the lack of Medicare coverage for Stem Cell Transplants for Myelofibrosis. We will let you know how to go about submitting a public comment ASAP.

Author: Michelle Woehrle

Michelle Woehrle joined the MPN Research Foundation in 2007 after being inspired by their mission to fund research that will improve the lives of people living with the rare blood cancers PV, ET and MF. In 2015 she was promoted to Executive Director. She has assisted with the expansion of the grants program, grassroots initiatives to connect with more patients internationally and optimize operations for the Foundation.

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