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At a recent meeting in Baltimore, MD, Grant Bagley, Director of Coverage and Analysis at the Health Care Financing Administration (HCFA), stated that Medicare coverage of chronic wound treatments-such as electrical stimulation and hyperbaric oxygen-are among the existing technologies that HCFA would like to review retrospectively, using more rigorous standards of evidence-based medicine.

One of the questions that HCFA has been pondering in terms of policies and practices for chronic wound healing is "whether hyperbaric oxygen therapy and electrical stimulation are even useful for chronic wound healing." Bagley stated that HCFA needs the flexibility to retrospectively apply more stringent evidence-based coverage standards to existing Medicare policies, citing chronic wound treatments as examples. It is not likely that formal review of old policies using evidencebased standards will occur frequently; however, when HCFA examines new technologies, coverage and payment policies for older products will likely be affected.
As HCFA reexamines coverage policies on older technologies, the newly created Medicare Coverage Advisory Committee will be providing input and a way for HCFA to demand and evaluate scientific evidence and data on clinical practice.

HCFA is working on a Federal Register notice on Medicare coverage criteria, which is planned for a fall release.

Karen Simon, JD, contributes to Policy & Practice. She is currently a Medicare consultant, Any information on reimbursement is provided as a service to readers but does not constitute, guarantee. or warranty that payment will be provided. Providers are responsible for case-bycase assessment of qualifications for reimbursement

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