Matters
- Coverage, Coding and Reimbursement, including establishing and revising Medicare’s local coverage determinations (LCDs), Medicare’s national coverage determinations (NCDs), policies involving Medicare’s physician fee schedule (MPFS), hospital outpatient prospective payment system (hospital OPPS), transitional pass-through (TPT) submissions, new technology add-on payment (NTAP) submissions and coding requests before the HCPCS Workgroup (relating to Level II HCPCS codes).
- Congressional and Federal Agency Lobbying, including developing draft policies, comments, position papers, legislative language and implementing advocacy strategies before the Centers for Medicare & Medicaid Services (CMS), Food and Drug Administration (FDA), U.S. Congress, Medicare Administrative Contractors (MACs, including DME MACs), HCPCS Workgroup (for securing new and revised HCPCS codes), American Medical Association’s CPT Panel (for securing new and revised CPT codes) and Medicare’s Pricing Data Analysis and Coding (PDAC) Contractor.
- CPT Coding, including work with manufacturers, professional societies and the American Medical Association’s CPT Panel on the establishment, revision and valuation of CPT codes.
- Healthcare Legal Issues, including contracting and compliance with federal and state laws concerning fraud, abuse and waste.
- Issues involving a wide range of medical technologies, services and innovations, including medical devices, digital health technology, artificial intelligence, radiation oncology technology, brachytherapy sources, radiopharmaceuticals, branded and generic pharmaceuticals, biologics and biosimilars, ophthalmology procedures, otolaryngology technologies, cardiovascular interventions, orthotics, durable medical equipment (DME), wound care products, skin substitutes, orthopedic implants and other technologies.
