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This is someone who has a health plan under Medicare. Benefit This refers to medical services covered by your health plan. This word is also used to describe your health plan in general. It can also mean payment received under a plan. Benefit duration This is the length of time that benef...
Note: Aetna follows Medicare DME MAC rules with respect to the usual medically necessary quantity of supplies for positive airway pressure devices. Upon individual review, positive airway pressure devices are considered a medically necessary form of non-invasive ventilation for members with lung disease ...
However, the Center for Medicare and Medicaid Services has deemed delivery of US via a hands-free unit to be investigational. This investigator examined the effectiveness of tissue heating with a hands-free US technique compared to a hand-held US transducer using the Rich-Mar AutoSound unit. A ...
The CMS Decision Memorandum states: "At this time, there is insufficient evidence to determine that percutaneous LAAC improves health outcomes compared to non-invasive guideline recommended first line standard medical therapies for Medicare beneficiaries with NVAF. We recognize the initial evidence is ...
The authors concluded that the use of HBOT neither improved the likelihood that a wound would heal nor prevented amputation in a cohort of patients defined by Centers for Medicare and Medicaid Services eligibility criteria. They noted that the usefulness of HBOT in the treatment of diabetic foot ...
Aetna's medical necessity criteria for external infusion pumps for diabetes have been adapted, in part, from Medicare national policy on external insulin infusion pumps, as outlined in CMS's Coverage Issues Manual Section 60-14. Documentation of continued medical necessity of the external insulin ...
A technology assessment of self-monitoring of blood glucose in persons with type 2 diabetes prepared for the Centers for Medicare and Medicaid Services (Balk et al, 2006) commented that "currently, CGM [continuous glucose monitoring] has been studied primarily in children with type 1 diabetes. It...
The Centers for Medicare & Medicaid Services observed that 3 of the new studies report on registry data; CMS noted that, as with all case series type studies, these studies are difficult to interpret without additional studies that reduce the possibility of inherent biases and substantiate the ...
CMS IOM Publication 100-02, Medicare Benefit Policy Manual; CMS IOM Publication 100-03 Medicare National Coverage Determination Manual. Medicare Coverage Determinations: Centers for Medicare & Medicaid Services (CMS), Medicare Coverage Database [Internet]. Baltimore, MD: CMS; updated periodically. Avail...