Autologous stem cell transplantation (AuSCT) is a process in which stem cells are harvested from a patient’s bone marrow or peripheral blood, stored, and then transplanted back into the patient following high dose chemotherapy used to treat various malignancies.
Currently section 110.8.1 of the National Coverage Determination (NCD) manual (CIM §35-30) states that this procedure is covered via contractor discretion for patients 63 years of age and under. As of October 1, 2000, primary AL amyloidosis has a national non-coverage determination for Medicare beneficiaries 64 years of age or older.
At the conclusion of the initial coverage determination CMS agreed to reconsider this coverage determination if new evidence became available. The requestors have submitted new data relating to this transplant procedure that was not available at the time of the original determination.
· CMS interpretation of the evidence and
· CMS decision.
CMS is requesting public comments on this proposed decision memorandum pursuant to Section 731 of the Medicare Modernization Act.