Competitive Tech's Calmare® Pain Device Therapy Garners Favorable Medicare Coverage Judgment
Ruling Appeal Establishes Calmare Treatments a "Medical Necessity" In Cancer-Related Chemotherapy Pain Case
PR Newswire Competitive Technologies, Inc.
11 minutes ago
FAIRFIELD, Conn., Jan. 15, 2014 /PRNewswire/ -- Competitive Technologies, Inc., (CTTC) (CTI), a biotechnology company, received a favorable Medicare treatment coverage judgment for its flagship medical technology device, the Calmare® pain therapy medical device, stemming from an appeal filed by an authorized Calmare practitioner in Staten Island, the Physical Medicine and Rehabilitation Associates of Staten Island, LLP (collectively, the Calmare Pain Relief Solutions or CPRS), by and through, Christopher M. Perez, M.D. U.S. Administrative Law Judge LeAnn R. Canter allowed the appeal, which resolved claims for Medicare coverage for a named Medicare enrollee (Beneficiary). The appeal allows CPRS to receive reimbursements for treatments using the Calmare Therapy for claims made in behalf of beneficiary.
In the early part of 2011, CPRS was denied Medicare payments for treatments rendered to a Beneficiary who was 69 years old, at the time of the treatment. The Beneficiary had a medical history of breast cancer, for which she had undergone mastectomy and chemotherapy treatments. She had pain from the cancer-related chemotherapy treatments that had an intensity level of 7 on a scale of 10, and a pain recurrence of 75% of the time.
The Calmare treatment was denied reimbursement coverage mostly due to the lack of inclusion of a Current Procedural Terminology (CPT) treatment code descriptor that would apply to the treatment type inherent to Calmare pain treatment therapy. CPRS filed an appeal (ALJ Appeal No 1-1009277156) to the Department of Human Services Office of Medicare Hearings and Appeals Midwestern Field Office in Cleveland, OH.
Judge Canter's ruling established that there was reliable evidence and sufficient d
"...Calmare Pain Relief Solutions, which developed the technology."???
Gee, what happened to MISTER Marineo -- did CTTC disown him or what?
"This ruling came after an appeal by a physicians group which protested Medicare's 2011 coverage denial..."
I got it now -- this article is just a REPLAY of that PR released two WEEKS ago about those two Caribbean med school grads who spent THREE YEARS trying to get approval for a $40 a treatment reimbursement from Medicare.
Desperate times calling for desperate measures, huh?
"The Medicare decision allows for the device to be covered as a "medical necessity"..."???
Well, no, not exactly . As I have pointed out before, Medicare has always been willing to reimburse anything that came with a letter from a physician indicating medical neceessity -- how MUCH they would reimburse, however, is an entirely different issue. They're not going to pay more for a TENS treatment just because of vacuous claims by the providers.
And would you look:
"This ruling will help broaden Calmare's patient reach and treatment efficacy...president & CEO Conrad Mir said..." Well, Conrad, you're just going to have to explain to me how a Medicare appeal ruling improves the "treatment efficacy" of the device.
Competitive Technologies wins a favorable Medicare coverage decision for its Calmare device, with labeling as a "medical necessity."
Competitive Technologies lands Medicare coverage for pain management device
Competitive Technologies said it secured a favorable decision concerning Medicare coverage for its Calmare pain management device.
The Fairfield, Conn.-based medical device company develops products for wound and pain management. The Calmare is the company's flagship product, and is used to treat neurological pain.
The Medicare decision allows for the device to be covered as a "medical necessity" in cancer-related chemotherapy treatment. The reimbursements will go to the Calmare Pain Relief Solutions, which developed the technology.