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Obtaining CMS Reimbursement for a Medical Device

Goal:

Secure the appropriate reimbursement rate for wound healing device.

Results:

Explained criteria and process for changing the reimbursement rate, then created the strategy of targeting CMS and Capitol Hill to educate, develop champions for the cause, and influence the process

Built a coalition of medical professionals to share their expertise and demonstrate not just how the wound healing device is reasonable and necessary, but also how complex it is to use that includes several steps that cost money

Coached the company on who to target, what messages to use, and when to time meetings and interactions

Organized meetings with CMS to review medical publications and data on the procedure

Secured dozens of calls, letters and communications to CMS from Capitol Hill and other established medical professionals explaining the appropriate cost for the procedure and need for increased rate

CMS increased the rate 10 times the initial rate over a few years