Subject: Big news in the fight for medical nutrition equity!

 

The U.S. Department of Health and Human Services (HHS) has announced that it may rescind or reconsider National Coverage Determination 180.2 ("NCD"). This NCD prohibits Medicare coverage of orally ingested medical formulas for patients with genetic metabolic disordersThe notice was published in the Federal Register, at pages 39255-39256: www.govinfo.gov/content/pkg/FR-2021-07-23/pdf/.... following a lawsuit (Waters v HHS, Case No. 1:21-cv-170, United States District Court, Western District of Michigan) challenging the NCD by parents of a daughter with homocystinuria. If DHHS rescinds the NCD, coverage determinations could be made by local Medicare Administrative Contractors on a case by case basis. 

 

As our community knows all too well, this is a major issue for the metabolic patients we care for and this NCD has downstream impacts on coverage of medical formula by other payors so your public comments are needed and more important than ever! 

 

PLEASE provide comments to DHHS by 5 p.m. on Monday, September 132021 using one of the methods below. When commenting, refer to file code CMS-1751-P. 

 

1. Electronically: https://www.regulations.gov/commenton/CMS-2021-0119-0053

 

2. By mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1751-P, P.O. Box 8016, Baltimore, MD 21244-8016. Please allow sufficient time for mailed comments to be received before the close of the comment period.

 

3. By express or overnight mail: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1751-P, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 

 

Please also share with your patients and others as you are able!

 

--

Susan A. Berry, M.D

Professor, Division of Genetics and Metabolism

Departments of Pediatrics and Genetics, Cell Biology & Development

University of Minnesota

berry002@umn.edu