Medicare Moves to Expand Coverage for Bone Marrow and Cord Blood Transplants

Posted February 22nd, 2016 by Be The Match and filed in News
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In response to the request by Be The Match, the American Society of Blood and Marrow Transplantation (ASBMT), and The Center for International Blood and Marrow Transplant Research (CIBMTR), the Centers for Medicare & Medicaid Services (CMS) issued its decision to expand Medicare coverage for bone marrow and cord blood transplants to three new diseases. Medicare covers Americans 65 years of age and older as well as people with certain long-term and permanent disabilities.

Be The Match applauds CMS for its decision to expand coverage and ensure patient access to life-saving transplants. The new Medicare coverage expansion includes:

  • Sickle cell disease
  • Multiple myeloma
  • Myelofibrosis

Medicare’s coverage of transplant prior to the expansion decision included only leukemia, aplastic anemia, severe combined immunodeficiency disease, Wiskott-Aldrich syndrome and myelodysplastic syndromes (MDS).

The new Medicare coverage is through a Coverage with Evidence Development (CED).  This means that patients with these diseases must be enrolled in an approved clinical trial for Medicare to cover the transplant. Be The Match, the ASBMT, and the CIBMTR are working closely with CMS to design the necessary clinical trials. CMS will gather outcomes data from these clinical trials and in the future may decide to include these diseases in the National Coverage Determination (NCD) for transplant.

Hundreds of patients will benefit from this important coverage expansion. Our future advocacy efforts will continue to focus on patient access to care and further expanding Medicare’s coverage of bone marrow and cord blood transplants.

 

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