Inspire Medical Systems, Inc. Announces Additional Draft Local Coverage Determinations Proposing Coverage of Inspire Therapy


Inspire Medical Systems, Inc., a medical technology company focused on the development and commercialization of innovative and minimally invasive solutions for patients with obstructive sleep apnea, announced today that two additional draft Local Coverage Determinations (“LCDs”) were published proposing coverage of Inspire therapy.

The Medicare Administrative Contractors (“MACs”) issuing these two policies are National Government Services, Inc. (“NGS”) and CGS Administrators, LLC (“CGS”), which collectively represent 12 states. The two additional draft LCDs are available on the Medicare Coverage Database site for public review. The NGS public comment period runs from September 26, 2019 to November 9, 2019, and the CGS public comment period runs from October 30, 2019 to December 14, 2019. NGS and CGS will host formal review meetings during this process. The final LCDs are expected to be published in early 2020. Four other MACs, Noridian, Palmetto, Novitas Solutions, and First Coast Service Options, previously published their draft coverage policies. In total, these six MACs represent Medicare patients in 44 states and the District of Columbia.

The draft LCDs from NGS and CGS are consistent with the previous publication of proposed LCDs from Noridian, Palmetto, Novitas Solutions and First Coast Service Options, which state that for individuals with obstructive sleep apnea who are treated with hypoglossal nerve stimulation, the evidence is sufficient to determine that the technology results in a meaningful improvement in the net health outcomes when utilized as outlined in the LCDs. The criteria for potential patients identified in the draft policy are closely aligned with the approved U.S. Food and Drug Administration indication statement for Inspire therapy.

“With these two additional LCDs, Medicare patients in 44 states are expected to have access to Inspire therapy.  We look forward to the potential issuance of formal policies from NGS and CGS, and anticipate that the one remaining MAC will also soon issue a draft policy for Inspire therapy,” said Tim Herbert, President and Chief Executive Officer of Inspire Medical Systems.

NGS covers Medicare patients in Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont, and Wisconsin. CGS covers Medicare patients in Kentucky and Ohio.

One remaining MAC, Wisconsin Physicians Service Government Health Administrators, which covers Medicare patients in Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska, has yet to publish a draft LCD proposing coverage of Inspire therapy.

For additional information about Inspire, please visit www.inspiresleep.com.

 



October 8, 2019


Topic Area: Press Release


Recent Posts

Containing Candida Auris Across the Care Continuum

Containment becomes achievable, sustainable and far more effective for facilities that follow the same precautions, disinfectant standards and equipment rules.


Early Entry: Manager's Critical Role in Construction Planning

Facilities managers should seek a seat at the table early to shape decisions that affect operations and continuity of care from the onset.


OhioHealth Van Wert Hospital Earns Critical Access Hospital Designation

The program was established to help rural hospitals maintain local access to care by providing additional flexibility through a cost-based Medicare reimbursement model.


Designing a Home Away from Home

Ronald McDonald House Atlanta balances the familiarity of home with the demands of a high-use facility serving families of children receiving medical care.


Stephens County Hospital Becoming Part of Wellstar Health System

The transaction is expected to be completed toward the end of 2026, pending the conclusion of regulatory approvals.


 
 


FREE Newsletter Signup Form

News & Updates | Webcast Alerts
Building Technologies | & More!

 
 
 


All fields are required. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

 
 
 
 

Healthcare Facilities Today membership includes free email newsletters from our facility-industry brands.

Facebook   Twitter   LinkedIn   Posts

Copyright © 2023 TradePress. All rights reserved.