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26-07-2024, 11:01 AM
#21401
Member
I gave up, this kind of trading volume not suit me.....
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26-07-2024, 11:07 AM
#21402
Member
Originally Posted by snigmac
I think that is a possible interpretation of the messaging released today but I don't think this is the correct position now. I think it is more likely that there has been a change in position and there is no timeframe to work with unless Novitas/CMS says otherwise.
Although it is ambiguous, that's my interpretation also.
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26-07-2024, 11:50 AM
#21403
Member
Originally Posted by Mel
Although it is ambiguous, that's my interpretation also.
It is very ambiguous... Monday should bring more certainty... but also a higher price possibly
Last edited by snigmac; 26-07-2024 at 12:00 PM.
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26-07-2024, 12:16 PM
#21404
Member
Ops I thought the links to the lcds were down but they look to be online now..
Last edited by snigmac; 26-07-2024 at 12:18 PM.
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27-07-2024, 08:48 AM
#21405
This was posted on the other site.
Novitas has been granted an extension https://www.novitas-solutions.com/we...entId=00006150
No timeframe provided.
Also discussed on this blog https://www.discoveriesinhealthpolicy.com/
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27-07-2024, 09:22 AM
#21406
Originally Posted by Greekwatchdog
Novitas must be staffed by very slow readers. PEB and the AUA both provided submissions to Novitas in September last year.
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27-07-2024, 10:45 AM
#21407
Member
The news is positive in my opinion (less positive than if the lcd was withdrawn but still positive).
Reading into this, I suspect what has happened is that CMS has told Novitas that it is not on the right path and that significant time will likely be needed to have the LCD in a state where it is workable to advance. CMS could have given Novitas a 1 or 2 week oe 1 month extension (something with certainty), instead it has provided a indefinite extension. Firstly, for me this indicates that significant and careful reworking of the proposed LCD is required, else a shorter extension would have sufficed. The wording "An extension has been granted by CMS in order for all comments to be considered thoroughly", reads for me, that Novitas did a bad job with addressing comments and submissions. I wouldnt be suprised if one of the points that Novitas is having a hard time with addressing are the submissions made which indicate that Novitas is acting outside of powers and setting a incorrect threshold via reliance on the external knowledge bases (PEB, AUA and 21 and other parties commented on this). It is possible that the extension length is not indefinite however based on the email from Novitas and the the unstated nature, I suspect it is indefinite until otherwise.
Secondly, i also think that CMS and Novitas are going to be extra careful. An indefinite extension outside what is allowed puts both CMS and Novitas at risk of procedural unfairness and risk of litigation (from several companies). This second point could be potentially very powerful for the companies as it is incredibly unfair for CMS and Novitas to subject PEB, the other companies and Medicare users to so much uncertainty for a unstated period of time.
What I think will happen moving forward is that Novitas will take a long time to finalize the lcd and what will most likely happen as a outcome is that there will be something new to be worked with that has been built with consultation with stakeholders. During this time, this should provide PEB and other impacted companies with room to meet requirements.
This could represent a change in position which is significant and positive for the PEB but there are risks also.
Disc: holding, DYOR
Last edited by snigmac; 27-07-2024 at 11:31 AM.
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27-07-2024, 11:28 AM
#21408
"The wording "An extension has been granted by CMS in order for all comments to be considered thoroughly", reads for me, that Novitas did a bad job with addressing comments and submissions.
I wonder how much more time Novitas will need if they couldn't consider all comments thoroughly in ten months!
I agree it is extremely unfair to subject PEB and others to ongoing uncertainty for an unspecified amount of time.
Last edited by pierre; 27-07-2024 at 11:32 AM.
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27-07-2024, 11:34 AM
#21409
Member
Originally Posted by pierre
"The wording "An extension has been granted by CMS in order for all comments to be considered thoroughly", reads for me, that Novitas did a bad job with addressing comments and submissions.
I wonder how much more time Novitas will need if they couldn't consider all comments thoroughly in ten months!
I agree it is extremely unfair to subject PEB and others to ongoing uncertainty for an unspecified amount of time.
Medicare users and doctors will also be impacted. I'm unsure if PEB needs to reword it's disclaimer. Before the disclaimer could have read that cover may drop after 26 July 2024, now it's working with cover that could drop any week, how do u work with that as a medicare user or doctor lol
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27-07-2024, 11:53 AM
#21410
Originally Posted by snigmac
Medicare users and doctors will also be impacted. I'm unsure if PEB needs to reword it's disclaimer. Before the disclaimer could have read that cover may drop after 26 July 2024, now it's working with cover that could drop any week, how do u work with that as a medicare user or doctor lol
I believe that 45 days notice is given before any finalised change comes into force.
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