The Centers for Medicare & Medicaid Services Revise National Coverage Determination for Stem Cell Transplantation

The Centers for Medicare & Medicaid Services revise the National Coverage Determination of allogeneic hematopoietic stem cell transplantation (HSCT) for individuals with myelodysplastic syndromes (MDS) based on requests from ASH, ASTCT, NMDP, and CIBMTR.

CHICAGO, IL / ACCESSWIRE / March 22, 2024 / The Centers for Medicare & Medicaid (CMS) Services revised the National Coverage Determination (NCD) of allogeneic hematopoietic stem cell transplantation (HSCT) for individuals with myelodysplastic syndromes (MDS) due to a request for reconsideration prepared by The American Society of Hematology (ASH), the American Society for Transplantation and Cellular Therapy® (ASTCT®), the National Marrow Donor Program (NMDP), and the Center for International Blood and Marrow Transplant Research (CIBMTR) on January 5, 2024.

Allogeneic HSCT remains the only curative therapy for patients with MDS, a group of blood disorders in which the bone marrow does not produce enough healthy, functioning blood cells. MDS primarily impacts older adults, making Medicare coverage for HSCT essential for patients to access this life-saving treatment.

The final rule outlined in the NCD, expands coverage for allogeneic hematopoietic stem cell transplant using bone marrow, peripheral blood or umbilical cord blood stem cell products for Medicare patients with myelodysplastic syndromes.

The revised ruling offers full coverage to some MDS patients; therefore, the NCD removes Coverage with Evidence Development (CED) requirement currently tied to coverage for HSCT for Medicare beneficiaries with MDS. A CIBMTR study showed since approval of the CED in August 2010, the number of allogeneic HSCTs in the U.S. for patients 65 years and older more than quadrupled, demonstrating that insurance coverage in this population is an essential factor in providing access to HSCT.

"ASTCT believes Medicare beneficiaries with a diagnosis of MDS regardless of age should have access to HSCT. We are encouraged by the revised NCD but recognize there is still more work to be done to remove treatment and coverage barriers for our patients," said ASTCT president Corey Cutler, MD, MPH.

For more information on ASTCT's advocacy efforts, visit www.astct.org/Advocate.

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About The American Society for Transplantation and Cellular Therapy® (ASTCT®):

The American Society for Transplantation and Cellular Therapy (ASTCT) is an international professional society dedicated to improving the lives of blood and marrow transplant and cellular therapy patients. ASTCT represents more than 3,900 physicians, investigators, and other health care professionals from more than 45 countries. Our mission is dedicated to improving the application and success of blood and marrow transplantation and related cellular therapies. We strive to be the leading organization promoting research, education, and clinical practice in the field. For more information about ASTCT, visit www.astct.org.

Contact Information

Jennifer Kasowicz
ASTCT Marketing Director
jkasowicz@astct.org
(312) 673-4970

SOURCE: American Society for Transplantation and Cellular Therapy

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