In Unprecedented Action, CMS Posts List of 20 Potential NCD Topics

CMS tonight posted a list of 20 health care interventions that it said are potential candidates for national coverage review.  The list spans a variety of drugs, devices, and services.  Public comments on the list are due September 28. 

The CMS posting, while unprecedented, didn't come without warning.  In a guidance document finalized in April 2006, the agency had said:

"Before deciding whether to generate an NCD, CMS may consult with relevant beneficiary groups, professional bodies and/or manufacturers of the technologies in question using the public comment function available on the coverage web site. Specifically, we will usually announce potential topics that are being considered for internally-generated requests on our web site on a quarterly basis, and allow interested stakeholders to comment on these topics. The purpose of these announcements is both to enable interested parties to provide any additional information as well as comments. Furthermore, these announcements will provide advance notice to the public regarding potential topics that we are considering, and allow stakeholders to suggest additional topics for consideration, creating a more transparent and predictable NCD process.

"The public is encouraged to comment on potential topics and provide relevant evidence on whether a review should or should not proceed prior to the formal decision to open an NCD. We are attempting to balance the public’s desire to comment extensively on potential topics with the inherent resource and time constraints in the NCD process. Due to these resource and time constraints, the public comment function available on the coverage web site will be the primary tool used to solicit input regarding this stage of the NCD process; stakeholders bear the responsibility for reviewing the quarterly list and submitting comments or evidence that they believe to be relevant."

In all, the CMS action could be viewed as adding a new, early-stage component to the NCD process -- a process that over the years, for good or for ill, has taken on increasing structure.