James Bailey is the new CMS Medicare Pharmaceutical and Technology Ombudsman, a role Congress established in the 21st Century Cures Act to help expedite resolution of industry Medicare reimbursement concerns. The Ombudsman's office is charged with fielding questions from pharmaceutical, biotechnology, medical device, diagnostic product manufacturers, and other stakeholders regarding Medicare coverage, coding, and payment for new or existing products. While the new office cannot advocate for specific policies in this area, the office “can facilitate information exchange.” The Ombudsman also does not replace other formal appeals processes.
This article is presented for informational purposes only and is not intended to constitute legal advice.
