(YOUR LETTERHEAD)
(DATE)
(MAC NAME AND ADDRESS)
Dear Sir or Madam,
The purpose of this letter is to request the re-evaluation of the Medical Policy Article/Local Coverage Determination
restricting the use of intravenous iron therapy for treatment of anemia in our specific region. The current CMS
policy is neither cost-effective nor likely to improve patient outcomes. To the contrary, current policy is more likely
to increase cost with a potentially significant negative impact on clinical outcomes. The current coverage restrictions
are based on an incomplete and now outdated evaluation of the relevant medical literature. I am attaching a
publication with references developed by the Society for the Advancement of Blood Management, Inc. providing
you with compelling evidence and rationale for the MAC to amend the current policy to improve the care of so
many patients affected by anemia.
In summary anemia is epidemic and is associated with poor medical and surgical outcomes. Anemia is also an
independent risk factor for morbidity and mortality. Currently the restrictions providers face for treating anemia
encourage the use of blood transfusion to treat anemia which becomes a twofold issue; Exposing patients to a liquid
organ transplant that carries higher risk and harm than IV iron and secondly using an expensive already over utilized
resource in our healthcare community.
I am requesting as a healthcare provider faced with so many restrictions to care for my patients with anemia that
[MAC name] would take this request for a timely and serious review of the evidence base and follow the
recommendations set forth by the Society for the Advancement of Blood Management, Inc. Some of the other
regions of the country have already accomplished this amendment. Specifically, the patients in Medicare
Administrative Contractor Jurisdiction A have had the benefit of expanded coverage since November of 2014 thanks
to reconsideration of the published data by the medical leadership of NHIC, Corp. The patients in our region deserve
the same coverage and the higher quality, lower cost care, it would bring.
Sincerely,
(Your name)