October 14, 2020
ASPEN Supports the Retirement of the Home Parenteral and Enteral Nutrition Local Coverage Determination
ASPEN, in cooperation with the National Home Infusion Association (NHIA), have long been advocating for changes to the outdated Durable Medical Equipment (DME) Parenteral and Enteral Nutrition Local Coverage Determination (LCD) criteria. In July 2020, we met with the Medical Directors at the Centers for Medicare & Medicaid (CMS) to discuss evidence-based changes to the current LCD. The proposed changes were supported by a Task Force of the ASPEN Public Policy Committee led by Penny Allen in cooperation with NHIA. On October 8th ASPEN and NHIA received the following exciting news:
The DME MACs will be retiring the Parenteral Nutrition LCD (L33798) and Enteral Nutrition LCD (L33783), effective for claims with dates of service on or after November 12, 2020, due to the evolution of nutrition clinical paradigms. Coverage is outlined in the
National Coverage Determinations (NCD) Manual
(CMS Pub. 100-03), Chapter 1, Section 180.2. With the retirement of the LCD and Policy Article, providers and suppliers should refer to the CMS NCD 180.2 - Enteral and Parenteral Nutritional Therapy, which addresses coverage criteria for parenteral and enteral nutrition.
The retirement of the outdated PN and EN LCDs long supports ASPEN recommendations that nutritional therapies should be prescribed according to medical necessity for each individual patient taking evidence-based medicine and clinical judgment into consideration.
"It is timely that during Malnutrition Awareness Week, a week dedicated to creating awareness of the high rates of malnutrition in the United States, that CMS shows receptiveness to allowing physicians to apply current best practices to determine the clinical necessity of home-based nutrition therapies for patients," said Penny Allen, RD, CNSC, Chair of ASPEN’s Public Policy and Advocacy Committee and National Director of Nutrition Support for Optum Infusion Pharmacy. "These policy updates will allow Medicare beneficiaries that need parenteral and enteral nutrition to have access to cost-effective nutritional care in the comfort and safety of their own homes."
ASPEN and NHIA will be working together in the coming days and weeks to gain a clearer picture and hopefully help design what the new guidelines will be, based on the National Coverage Determination (NCD) for patients needing parenteral or enteral nutrition.