Medicare Coverage of Items
and Services in FDA Investigational Device Exemption Clinical
Studies--Revision of Medicare Coverage (CMS-10511)
Reinstatement without change of a previously approved
collection
No
Regular
07/18/2022
Requested
Previously Approved
36 Months From Approved
116
0
232
0
0
0
Section 1862(m) of the Act
(established by section 731(b) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173,
enacted on December 8, 2003)) allows for payment of the routine
costs of care furnished to Medicare beneficiaries in a Category A
investigational device exemption (IDE) trial and authorizes the
Secretary to establish criteria to ensure that Category A IDE
trials conform to appropriate scientific and ethical standards. By
providing Medicare coverage of routine costs in Category A trials,
the Congress removed a financial barrier that may have discouraged
beneficiaries from participating in these trials. It also gives
Medicare beneficiaries the opportunity to have earlier access to
new medical devices. Based on our rulemaking authority in section
1871 of the Act, we are applying the same Medicare coverage
requirements and scientific and ethical standards to Medicare
coverage related to Category B IDE studies/trials that would be
applicable to Category A IDE studies/trials. CMS (or its designated
entity) must review the following to determine if the Medicare
coverage IDE study criteria in ?405.212 are met for purposes of
coverage of items and services described in paragraphs (a) and (b)
of this section: (1) FDA IDE approval letter. (2) IDE study
protocol. (3) IRB approval letter. (4) National Clinical Trials
(NCT) number. (5) Supporting materials, as needed.
US Code:
42
USC 205(a) Name of Law: Social Security Act: EVIDENCE,
PROCEDURE, AND CERTIFICATION FOR PAYMENT
US Code: 42
USC 1102 Name of Law: Social Security Act: RULES AND
REGULATIONS
US Code: 42
USC 1861 Name of Law: Social Security Act: Part
E--Miscellaneous Provisions DEFINITIONS OF SERVICES, INSTITUTIONS,
ETC
US Code: 42 USC 1861 Name of Law: Social
Security Act
US Code: 42 USC 205(a) Name of Law: Social Security Act
US Code: 42 USC 1102 Name of Law: Social Security Act
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.