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Judicial Watch • Provenge Point 1

Provenge Point 1

Provenge Point 1

Page 1: Provenge Point 1


Number of Pages:1

Date Created:March 30, 2011

Date Uploaded to the Library:February 20, 2014

Tags:elements, Hecker, Contractor, provenge, Medical, Bernice, jacques, medicare, rogers, louis, service, william, ICE

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Please consider the environment before printing this email 
From: Medicare Contractor Medical Directors Behalf Jacques, Louis 
5ent: Monday, June 07, 2010 9:05 To: 
Subject: Re: F/U New Tech call: Provenge 
Absent CMS instructions tt1e contrary, local contractors have discretion cover noncover the various components the Provenge autologous immunotherapy program. 
-----Original Message----
From: Bernice Hecker 
Cc: Jacques, Louis (CMS/OCSQ); Syrek Jensen, Tamara (CMS/OCSQ) Subject: F/U New Tech call: Provenge requested, had discussion with CAG regarding potential Provenge coverage with evidence development. Bottom-line: how can anyone cover anything when are not yet sure what is? See below. 
The (Center for Medicare, formerly CMM the Center for Medicare Management) the CMS authority benefit category dete1T11ination, i.e. whether not item service falls within the Medicare insurance benefit, and so, which one(s). The Provenge autologous immunotherapy program comprises multiple discrete elements including the collection the patient's blood. the prcessing the patient's cells and the subsequent infusion the processed cells back into the patient. the current time, trying determine the preferred benefit category allocation for the elements Provenge. entirely unclear whether the elements would treated single bundled service not, how they should coded and priced yet. This being t.he case, seems that inform thQse seeking payment that neither nor CAG has authority pay this time and won't until decides what are paying. Interested parties might directed CMS. 
Bernice Hecker MD, MHA, FACC Medicare, Contractor Medical Director 
AK. rD, OR, MN, Jur. (AZ, MT, ND, SD, UT, WY) 000209