Ruling Appeal Establishes Calmare Treatments a "Medical Necessity" In Cancer-Related Chemotherapy Pain Case
Fairfield, CT -- (SBWIRE) -- 01/17/2014 -- Competitive Technologies, Inc.,(CTI), a biotechnology company, received a favorable Medicare treatment coverage judgment for its flagship medical technology device, the Calmare® pain therapy medical device, stemming from an appeal filed by an authorized Calmare practitioner in Staten Island, the Physical Medicine and Rehabilitation Associates of Staten Island, LLP (collectively, the Calmare Pain Relief Solutions or CPRS), by and through, Christopher M. Perez, M.D. U.S. Administrative Law Judge LeAnn R. Canter allowed the appeal, which resolved claims for Medicare coverage for a named Medicare enrollee (Beneficiary). The appeal allows CPRS to receive reimbursements for treatments using the Calmare Therapy for claims made in behalf of beneficiary.
In the early part of 2011, CPRS was denied Medicare payments for treatments rendered to a Beneficiary who was 69 years old, at the time of the treatment. The Beneficiary had a medical history of breast cancer, for which she had undergone mastectomy and chemotherapy treatments. She had pain from the cancer-related chemotherapy treatments that had an intensity level of 7 on a scale of 10, and a pain recurrence of 75% of the time.
The Calmare treatment was denied reimbursement coverage mostly due to the lack of inclusion of a Current Procedural Terminology (CPT) treatment code descriptor that would apply to the treatment type inherent to Calmare pain treatment therapy. CPRS filed an appeal (ALJ Appeal No 1-1009277156) to the Department of Human Services Office of Medicare Hearings and Appeals Midwestern Field Office in Cleveland, OH.
Judge Canter's ruling established that there was reliable evidence and sufficient documentation of the Beneficiary's medical conditions to establish the medical necessity of the Calmare Therapy treatments. In turn, the medical records and the hearing testimony supplied ample evidence that the treatments at issue greatly improved the Beneficiary's pain management over the brief course of treatment.
"This ruling will help broaden Calmare's patient reach and treatment efficacy," commented CTI President & CEO Conrad Mir. "Treatment reimbursement has been a challenge to the furtherance of Calmare. With this significant business milestone achieved, we anticipate greater treatment reimbursements moving forward, which may improve device sales to physicians."
About Calmare Pain Relief Solutions (CPRS) Calmare Pain Relief Solutions is a Physician group which specializes in offering a non-narcotic and non-invasive solution for chronic pain. Christopher Perez, MD and Jack D'Angelo, MD, specialize in physical medicine and rehabilitation and together have over 30 years of clinical experience treating chronic neuropathic pain.
About CPRS Physicians The physicians at Calmare Pain Relief Solutions, Christopher Perez, MD and Jack D'Angelo, MD, have been treating chronic pain patients suffering from neuropathies such as failed back surgery, Reflex Sympathetic Dystrophy (RSD/CRPS), and Chemotherapy-induced Peripheral Neuropathy (CIPN) since 2010.
About the Company
Competitive Technologies Inc., is a biotechnology company developing and commercializing innovative wound and pain mitigation products and technologies. CTI is the licensed distributor of the non-invasive Calmare® pain therapy medical device, which incorporates the biophysical "Scrambler Therapy"® technology developed to treat neuropathic and cancer-derived pain by Professor Giuseppe Marineo.
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