plan approved by the company’s secured lenders, commonly called a pre-packaged bankruptcy. Revere is acquiring CareMax’s management services organization (MSO) and ACO assets, including the Medicare shared savings program (MSSP) part of its MSO business that supports about 80,000 Medicare ...
Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does ...
Since surgery to correct a condition of "moon face" which developed as a side effect of cortisone therapy does not meet the exception to the exclusion, it is not covered under Medicare (§1862(a)(10) of the Act). An UpToDate review on “Overview of breast disorders in children and adole...
Aetna follows Medicare rules in considering osseointegrated implants, such as implantable BAHAs and temporal bone stimulators, as prosthetics. Medicare considers as prosthetics "osseointegrated implants, i.e., devices implanted in the skull that replace the function of the middle ear and provide mechan...
Medicare Local Medical Review Policy. Durable Medical Equipment Regional Carrier (DMERC) Regions A and B. Columbia, SC: Tricenturion; effective July 1, 1996. U.S. Food and Drug Administration. Relizorb enzyme packed cartridge. 510(k) No. K163057 (traditional). Silver Spring, MD: FDA; ...
This Clinical Policy Bulletin addresses bendamustine for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of bendamustine (Belrapzo, Bendeka, Treanda, Vivimusta, and bendamustine) is required of all Aetna participating provider...
Most Aetna benefit plans exclude coverage of hearing aids. Any applicable benefit plan exclusions and limitations for coverage of hearing aids would apply to air conduction hearing aids, implantable hearing aids and semi-implantable hearing aids. Please check benefit plan descriptions for details. ...
Centers for Medicare and Medicaid Services (CMS). Decision memo for infrared therapy devices (CAG-00291N). Medicare Coverage Database. Baltimore, MD: CMS; October 24, 2006. Choi SJ, Cho EH, Jo HM, et al. Clinical utility of far-infrared therapy for improvement of vascular access blood fl...
Aetna's HMO plans do not consider AFOs and any related addition medically necessary when used solely for the treatment of edema and/or for the prevention or treatment of a heel pressure ulcer in ambulatory patients, as Medicare does not consider AFO's medically necessary for these indications. ...
This Clinical Policy Bulletin addresses brexucabtagene autoleucel (Tecartus) for commercial medical plans. For Medicare criteria, seeMedicare Part B Criteria. Note: Requires Precertification: Precertification of brexucabtagene autoleucel (Tecartus) is required of all Aetna participating providers and ...