Medicare Set Aside News - CMS Announces TENS Unit Decision Memo
The Centers for Medicare and Medicaid Services (CMS) have announced a Decision Memo regarding Transcutaneous Electrical Nerve Stimulation (TENS) units.
On June 8, 2012, CMS released a Decision Memo that addressed conditions for coverage of a TENS unit for Chronic Low Back Pain (CLBP). The recent change in coverage of TENS units for CLBP will have the following impacts upon the WCMSA proposal review process for Medicare Set Asides:
- Effective June 8, 2012, for those workers' compensation (WC) Medicare Set Aside cases settled prior to June 8, 2012, and where the settlement included pricing for TENS for CLBP, CMS will consider funds spent for TENS for CLBP by beneficiaries and claimants as being an appropriate expenditure of funds as part of the WCMSA.
- For those WC cases that were not settled prior to June 8, 2012, and where the WCMSAs proposal includes funding for TENS for CLBP as part of the WCMSA, CMS will re-review the cases and remove pricing for TENS for CLBP. (Regional Offices shall obtain from submitters requests for a case re-review, along with a signed statement indicating a settlement had not occurred prior to June 8, 2012.)