2019 Coalition Achievements

The Coalition Wound Care Manufacturers, as the collective collaborative industry voice, advocates for changes in coding, coverage and payment policies to ensure patient and provider access to wound care products and services.

  • Directly responsible for impacting HCPCS code application process by convincing the Centers for Medicare and Medicaid Systems (CMS) to allow manufacturers to submit Healthcare Common Procedure Coding System (HCPCS) billing code applications for devices twice a year and drug and biologics four times a year. This will allow new products to come to market more quickly. 

  • Enhanced the wound expertise of PDAC/DMEMAC staff and medical directors by co-hosting a two-day educational session at Palmetto GBA focused on the complexities of wound care and lymphedema management and clinical best practice when selecting and applying treatments. The program provided the opportunity for staff to see and try products to understand their uses and differences; compared coverage policies with current clinical practice. An educated staff will ultimately drive more clinically accurate coverage policies and coding verification decisions.

  • Prompted CMS to publish an updated MedLearn Matters: Following several months of Coalition advocacy, calls and meetings with CMS, its Ombudsman and its MLN Matters team, an updated MLN Matters was published in June 2019 addressing billing issues that the Coalition had flagged to the Agency related to disposable negative pressure wound therapy (dNPWT). The Coalition had provided recommendations, instructions and visuals of billing process screens to document where common mistakes were being made and where clarification was needed.

  • Elevated Coalition concerns with competitive bidding processes via comments to the DMEPOS Competitive Bidding Proposed Rules of the CY 2020 End-Stage Renal Disease PPS and while attending the September Medicare Payment Advisory Commission (MedPAC) session.

  • Expanded CMS payment staff’s understanding of wound care complexities as it continues to develop its CTP payment methodologies, by submitting guidance and recommendations in comments to CMS’s Hospital Outpatient Payment System proposed rule.

  • Monitored policies, flagged issues, alerted members to relevant public meetings and opportunities to comment, and provided access to CMS, DMEMAC and PDAC staff as well as thought leaders and key policy decisionmakers throughout the year.

  • Served as an active supporter and participant in Alliance of Wound Care Stakeholders activities to ensure that the wound care provider clinical expert voice is proactively speaking to the impact of policies on patients and providers (See www.woundcarestakeholders.org).

For more detailed information on activities, as well as information from prior years, click the links below:

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