Recently the Centers for Medicare and Medicaid (CMS), the agency that determines government reimbursement policy, proposed policy changes that, if approved, would impact Medicare coverage for erythropoiesis stimulating agents (ESAs) in the management of patients with myeloma. Many myeloma patients are currently being treated with ESAs, reducing or eliminating their need for transfusions. The IMF has weighed in with CMS regarding the myeloma community's concerns with the proposal.
To view the IMF's letter to CMS, please click here.
A copy of the CMS proposal is available at
Implications of this proposal include:
Interferes with the doctor patient relationship in deciding the best treatment options for myeloma patients.
Significantly increases patient out-of-pocket costs for ESA therapy by limiting or denying reimbursement.
Sets a dangerous precedent for national policy by ignoring evidence-based standards of high quality myeloma care.
While the IMF and others within the cancer community have weighed in on this proposal, we encourage the myeloma community to also send comments to CMS. Even if you do not have Medicare coverage, it is important to comment by the deadline because there is always the possibility that private insurance carriers will follow the Medicare policy. The comment period for the proposal ends on June 13, 2007. CMS is required to make a final coverage determination within 60 days after the end of the public comment period.
To forward comments on this proposal to CMS, please click here.
(If you have a problem accessing the comment form, cut and paste this URL into your browser: http://www.cms.hhs.gov/mcd/public_comment.asp?id=&cov_id=&state_id=&list_type=&goto=publiccomment&nca_id=203&basketitem)
The IMF will monitor the outcome of this issue and will keep the myeloma community informed on the final decision.