Earlier this year, the American Venous Forum and AVF Foundation adopted “Healthy Veins for Healthy Life.” One of our 4 strategic “Healthy Veins” initiatives is to Advocate for Access. Two objectives of this initiative are to:
- Promote evidence-based best practices to ensure that all patients have access to the highest quality care. This includes access for all patients, regardless of where they choose to live.
- Become point society for questions from the FDA, CMS, 3rd party payers, RUC and MEDCAC. The AVF would be an optimal clearing house for insurance and government issues.
On 7/24/18, the American Venous Forum took another step forward in support of these goals.
Under the direction of the Health Policy committee chairs, Fedor Lurie and Kathleen Ozsvath, and AVF leadership BK Lal (President-Elect), Hal Welch (Vice-President), and Elna Masuda (President), the AVF group met with the Coverage and Analysis Group (CAG) of the Centers for Medicare and Medicaid of the Department of Health and Human Services at the CMS headquarters in Baltimore.
Representing CMS were Tamara Syrek Jensen (Group Director, CAG), Joseph Chin (Deputy Group Director, CAG), Lori Ashby (Division Director-Division of Policy and Evidence Review), Marie Casey (Program Management Officer, CAG), Jyme Schafer (Medical Officer, CAG) and David Dolan (Analyst, CAG).
This was not our first meeting with CMS. The AVF met with CMS in April of 2016 and May of 2017. AVF representatives also participated in CMS meetings with the Wound Care Alliance in November of 2015 and January of 2016.
This meeting focused on the issue of inconsistent local coverage determination and opportunities to harmonize reimbursement policies for the treatment of patients with venous disease across the nation.
The actions taken following our CMS meeting a year ago and their results were discussed. We also talked about opportunities to collaborate in addressing remaining obstacles and new challenges for securing and maintaining patients’ access to appropriate care.
The meeting featured extremely friendly conversations, a complete reversal on the NCD issue, an openness to the idea of a disease-targeted NCD, and a willingness to work together closely in the future.
This productive meeting resulted in a plan of action that will be refined and serve as the basis for increasingly close collaboration between the American Venous Forum and the CMS.
Together with CMS, the American Venous Forum has taken another large step forward in pursuit of “Healthy Veins for Healthy Life.”