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have one. Be as specific as you wish. Recognize the agency is attempting to implement a law and is compelled to do so. Comments such as “the law is silly” or “the law does not protect the rights of XYZ group” are a waste of time for a regulator. Address the proposed regulation rather than proposing changes to the statue. 10. Explain your rationale for your opinion, clearly, succinctly, and cogently. 11. Be polite. You are writing to a human being who will judge your respect, wisdom, intelligence, relevance, knowledge base, and politeness. A cogent comment to a proposal, correctly understood, gains respect and may be actionable. 12. Assume the reader of your comment is working in good faith. 13. Cite appropriate references, if available. 14. Cite relevant similar precedents that have been effective. 15. Do not insult the reader. Pretend you are writing to a friend whom you like. 16. Shorter is better − it shows mastery of the subject and respect for the reader. 17. Anything longer than two pages is too long. 18. Do not repeat yourself. 19. Use as few words as possible. 20. Use a thesaurus, when needed, for verbal precision. 21. Do not use references to unknown persons, such as “they.” Pronouns without reference cause confusion. 22. Keep your political philosophy to yourself. 23. Avoid extrapolating the proposal into gloom and doom predictions. For example, if the policy proposes to restrict access to a medication, do not assume innocent people will die and the Medicare Program will self-destruct. 24. Sometimes a proposal that is not exactly on target will be considered when compiling a subsequent rule. Not every innovative idea is internally generated.

25. Use active tense verbs. Example: August 27, 2012 VIA Electronic Mail to: glenn.mcguirk@cms.hhs.gov Marilyn Tavenner Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 RE: Medicare Program; Public Meeting in Calendar Year 2012 for New Clinical Laboratory Tests Payment Determinations [CMS-1441-N] Dear Ms. Tavenner: Please consider my comment as part of the above public meeting. I propose the following: CMS administer Molecular Diagnostic (MolDx) tests in the same manner as it does for DME equipment by using: (1) A PDAC-like contractor to assign a unique code to each unique test or set of same tests from a unique category of HCPCS codes; (2) A laboratory specialty contractor to determine medical necessity for each test based on scientific evidence, with notice and comment, just like the four DMEPOS MACs do now for DME items. Rationale: CMS and its contractors cannot consistently identify each laboratory-developed test provided because some may be billed with a stack of process CPT codes that are not test specific. AMA refuses to provide brand-specific CPT codes. Most MolDx tests are unique. To determine medical necessity under the statue 1862(a)(1)(A), each test and its purpose must be identifiable. Brand-specific coding, and generic bundling when appropriate, may better enforce the law. Unique codes will allow for faster electronic processing and proper payment determination. Thank you for the opportunity to comment. Respectfully− continued on next page

July/August 2015

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Profile for Sierra Sacramento Valley Medical Society

2015-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...

2015-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...