CMS continues its commitment, through national coverage determinations (NCDs), to ensure that people with Medicare have access to emerging treatments and technologies that will improve health outcomes.

October 10: CMS announced that the final NCD on Preexposure Prophylaxis (PrEP) Using Antiretroviral Therapy to Prevent Human Immunodeficiency Virus (HIV) Infection would not be posted by the expected date of October 10. CMS received comments on the proposed NCD that expressed concern over the potentially complex transition of coverage of these preventive drugs from Part D to Part B.  CMS will work with Part D plans and pharmacies to facilitate an orderly transition as we work towards finalizing the NCD. A final NCD will be forthcoming. Information on the proposed NCD is found here.

October 11:  CMS issued a final NCD for Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting. This NCD resulted from a request from the Multispecialty Carotid Alliance (MSCA) for a reconsideration of a former NCD. The procedure restores blood flow when arteries are clogged due to peripheral artery disease. In the final NCD, CMS expanded coverage of PTA of the carotid artery with stenting for a broader population and allowed Medicare Administrative Contractors (MACs) to make reasonable and necessary determinations for any other beneficiary seeking coverage.

October 13: CMS announced a final decision to remove the NCD for Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease, permitting Medicare coverage determinations to be made by the MACs. Removing the NCD also removes the current limitation of one PET beta-amyloid scan per lifetime from the coverage requirements.