Iridex Corporation announced all five Medicare Administrative Contractors (“MACs”) retired their local coverage determinations (“LCDs”) that were scheduled to take effect on January 29, 2024.
Iridex and other stakeholders opposing the LCDs have engaged with the MACs throughout the comment period to advocate for continued patient access to clinically proven safe and effective glaucoma treatments. The Company applauds the decision which effectively retains reimbursement and full access for Medicare patients to all Iridex cyclophotocoagulation products.
“We appreciate the engagement with us by the MAC administrators, from the initial correction of criteria for coverage to the conference call with the group to discuss appropriate broadening of qualifying patients. By retiring the LCDs, the MACs have supported continued access to advanced patient care like MPTLT,” said David I. Bruce, president & CEO, Iridex Corporation.
“We thank the numerous glaucoma surgeons across the country, as well as the various societies, notably the American Academy of Ophthalmology, the American Glaucoma Society, the American Society of Cataract and Refractive Surgery, and the Outpatient Ophthalmic Surgery Society for their support and advocacy throughout the process.
The groundswell of reaction to the LCDs was critical in providing persuasive feedback during the Notice Period before effectiveness, leading to this action in support of glaucoma patient care."
Between October 24th, 2023 and November 9th, 2023, five of the seven MACs published LCDs targeting MIGS procedures, which also partially restricted criteria for coverage of cyclophotocoagulation reimbursement. Due to these proposed LCDs, the cyclophotocoagulation procedures performed by Iridex’s G6 laser system and probes would have been partially affected by restrictions of the criteria to deem the procedure medically necessary and provide coverage.
As of today, all five MACs, WPS Government Health Administrators, Palmetto GBA, Celerian Group Company, National Government Services, and Noridian Healthcare Solutions, have now issued statements that the final LCDs will not go into effect on January 29, 2024.
As a result, there will be no change in January 2024 to the current Medicare coverage for MIGS procedures performed with Iridex MicroPulse TLT.