National Coverage Determinations

When the Centers for Medicare & Medicaid Services (CMS) makes changes to the services that are covered, they update them through National Coverage Determinations. Learn more about National Coverage Determinations on their website. CMS has issued these National Coverage Determinations:

Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing, Effective February 2016

Centers for Medicare and Medicaid Services (CMS) has determined that, effective for dates of service on or after July 9, 2015, evidence is sufficient to add preventative coverage for HPV testing under specified conditions. In accordance with CMS guidance, Health Alliance will allow for coverage of this service when the specified criteria are met.

Screening for Human Immunodeficiency Virus (HIV) Infection, Effective February 2016

Centers for Medicare and Medicaid Services (CMS) has determined that, effective for dates of service on or after April 13, 2015, evidence is sufficient to add preventative coverage for HIV testing under specified conditions. In accordance with CMS guidance, Health Alliance will allow for coverage of this service when the specified criteria are met.

Percutaneous Left Atrial Appendage Closure (LAAC), Effective May 2016

Centers for Medicare & Medicaid Services (CMS) have determined that, effective for dates of services on or after February 8, 2016, evidence is sufficient to add coverage for percutaneous Left Atrial Appendage Closure (LAAC) when all specified conditions are met. In accordance with CMS guidance, Health Alliance will allow for coverage of this service when the specified criteria are met.

Stem Cell Transplantation for Multiple Myeloma, Myelofibrosis, and Sickle Cell Disease, and Myelodysplastic Syndromes, Effective July 2016

Centers for Medicare & Medicaid Services (CMS) issued a final decision, effective for dates of service or on after January 27, 2016, to expand national coverage of items and services necessary for research in an approved clinical study via Coverage with Evidence Development for allogeneic Hematopoietic Stem Cell Transplantation (HSCT) for treatment of Multiple Myeloma, Myelofibrosis, and Sickle Cell Disease, but only if provided in the context of a Medicare-approved clinical study meeting specific criteria. In accordance with CMS guidance, Health Alliance will allow for coverage of this service when the specified criteria are met.