Proposed Decision Regarding National Coverage Analysis of MAT® Treatment
In August, Dr. Aoki was delighted to personally present information about the scientific aspects of MAT® treatment, its history and long term safety record to a meeting of CMS and FDA staff.
In mid-
Unfortunately the CMS Proposed Decision included many misunderstandings regarding MAT® treatment. Hopefully these misunderstandings will be corrected when CMS discusses the therapy with medical experts before their Final Coverage Decision. Insurance providers such as Medicare have had difficulty in the past understanding this unique therapy and the published scientific data supporting its use. Response to many of the Medicare concerns can be found in the Response by Dr. Aoki to the Blue Shield Technology Assessment of 2001. Ultimately, the California Courts ruled that Blue Shield could not deny payment for the patients receiving MAT® treatments at ADRI. Another very cogent argument on whether MAT® treatment is “reasonable and necessary” is contained in the Administrative Law Judge’s decision requiring CalPERS or it’s third party administrator to provide payment for this therapy.