LCD Reference Article Response To Comments Article

Response to Comments: Allogeneic Hematopoietic Cell Transplantation (HCT) for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

A59289

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Source Article ID
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Article ID
A59289
Original ICD-9 Article ID
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Article Title
Response to Comments: Allogeneic Hematopoietic Cell Transplantation (HCT) for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin
Article Type
Response to Comments
Original Effective Date
01/05/2022
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This article addresses comments received by CGS Administrators on the proposed policy addressing allogeneic HCT for primary refractory or relapse of Hodgkin's or non-Hodgkin's lymphoma with B-cell or T-cell origin presented at Open Meeting on October 25 and 26, 2022.

Response To Comments

Number Comment Response
1

A comment was received from the American Society of Hematology (ASH) and the American Society for Transplantation and Cellular Therapy (ASTCT) expressing support of the proposed draft. They state “the Medicare NCD for allogeneic stem cell transplantation (110.23) does not specifically include lymphoma as a covered indication, leaving Medicare beneficiaries with lymphoma without access to this potentially curative treatment and creating different standards of care under Medicare then what is afforded to patients with commercial insurance. For the subset of lymphoma patients who are prime candidates, allo-HCT, is there only option for curative intent therapy, making this LCD critically important. ASH and ASTCT believe uniform language will help to avoid regional differences in interpretation and express thanks for the development of the LCD.”

Thank you for your comments and support.

2

The College of American Pathologist (CAP) express support for the proposed coverage policy stating: “The CAP is supportive of CGS’ proposal that would bring additional local coverage to Medicare patients of all ages for allogeneic stem cell for primary refractory or relapsed Hodgkin's and non-Hodgkin's lymphoma with B-cell or T-cell origin, for whom there are no other curative intent options, and are medically necessary. We would like to express our thanks to CGS for recognizing advances in transplantation technology for HCT procedures and for expanding local coverage in accordance with National Coverage Determination (NCD) 110.23, which allows contractor discretion of coverage and reimbursement for entities neither specifically included nor excluded from coverage by the NCD.”

Thank you for your comments and support.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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