The Coalition includes in its work plan not only general Medicare and Medicaid coding, coverage and reimbursement
issues, but also specific wound care issues
as they emerge and evolve. The Coalition functions as the respected and credible unified voice of wound care manufacturers to private/public payers and government entities to ensure patient access to wound care products and services. We accomplish this by:
- Ensuring the Coalition’s voice is heard when advocating for accurate and adequate coverage, coding and payment for wound care products and services by performing these activities:
- Submitting comments on draft LCDs impacting wound care to the DMEMAC and A/B MACs (including but not limited to: negative pressure wound therapy, cellular and/or tissue-based products for wounds, surgical dressings, debridement).
- Reviewing CMS and FDA proposed regulations (Outpatient Prospective Payment System, Physician Fee Schedule, Durable Medical Equipment Prosthetic and Orthotic Supplies, etc.) for assessment of wound care industry impact and comment as appropriate.
- Meeting with CMS, FDA or other relevant agencies and/or Congressional offices as needed to educate agencies on the Coalition’s behalf.
- Voicing concerns regarding process issues with all governmental agencies (including PDAC, DME MAC and FDA) by attending meetings and submitting comments.
- Assisting members to better understand Medicaid and private payers wound care coverage and payment policies.
- Monitoring and taking action when necessary on these issues when they impact wound care: prior authorization and competitive bidding.
- Collaborate with and support the Alliance of Wound Care Stakeholders in addressing wound care issues such as:
- Medicare payment reform initiatives such as Merit-based Incentive Payments Systems and Alternative Payment Methods
- Securing alignment with key stakeholders to develop wound care quality measures (i.e., CTPs, NPWT, pressure ulcer/injury prevention
- Appropriate coverage, coding and payment of wound care products and services
- Collaborate with and support the Alliance of HCPCS Coding Reform.
- Providing members with access to key policy decision makers and educating them on timely and important issues through in-person seminars.