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MiMedx Group, Inc. (NASDAQ: MDXG) announced that Medicare contractor, CGS, has confirmed that the Company's wound care allograft, EpiFix®, has received reimbursement coverage from CGS. The coverage by CGS now brings the total Medicare Administrative Contractors (MACs) covering EpiFix® to six of the eight and 86% of Medicare beneficiaries will now be eligible for coverage for EpiFix® products.
"We have been persistent in executing our strategy to gain MAC coverage throughout the country," said Parker H. "Pete" Petit, Chairman and CEO. "With the additional coverage by CGS encompassing the states of Kentucky and Ohio, we have further expanded the opportunity for Medicare beneficiaries suffering from chronic wounds to have access to our clinically and cost effective allografts."
CGS approved EpiFix® for both diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) that fail to respond to standard of care treatments. The approval was retroactively effective to November 1, 2013. Of the six MACs that cover EpiFix®, five cover both DFUs and VLUs.
Currently, two of the largest categories of chronic wounds are DFUs and VLUs. A clinical study of over 300,000 wounds reported the median size of a DFU to be 1.35 cm2 and the median size of a VLU to be 2.32 cm2. Widely used legacy skin substitute products are only offered in fixed sheet sizes of approximately 40 cm2, which leads to tremendous wastage in treating both DFUs and VLUs.
Bill Taylor, President and COO, stated, "Recently, the Centers for Medicare and Medicaid Services (CMS) announced a change in the way skin substitutes will be reimbursed beginning in 2014. The change bundles reimbursement for the cost of the product with the fee for the related surgical procedure. The change incentivizes physicians to use more cost effective skin substitutes. We supported the change and educated congressional members about the excessive wastage history in the skin substitute product area to encourage them to support the change as well. We are pleased that the payers are embracing this cause and consistently adding our cost effective EpiFix® allografts to their coverage authorizations."
"We look forward to continuing to provide our clinically and cost effective allograft, EpiFix®, for advanced wound healing. By offering providers various sized product to more closely match actual wound sizes, EpiFix® allografts can eliminate unnecessary wastage of product compared to many other available skin substitute products," added Petit.