Deborah Godes

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Deborah is a seasoned regulatory and reimbursement consultant, advising clients on reimbursement and policy strategy for medical devices, diagnostics, biologics and health services with public and private payers. She focuses primarily on market access (e.g., coding, coverage, payment and other reimbursement models) for new and existing products and services, including AI-powered solutions. She has more than 20 years of experience providing strategic, operational and policy consultative services to companies of all sizes, from start-ups to Fortune 100 companies. Deborah offers clients the ability to analyze and manipulate reimbursement databases to buttress data-oriented policy positions. Read Deborah Godes's full bio.

Remote Monitoring and Digital Therapies: CMS Updates Coverage and Payment Policies

By , and on Dec 26, 2023
Posted In Employee Benefits, Health and Welfare Plans

In recent years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to pay for non-face-to-face services that improve care coordination for Medicare beneficiaries. On November 2, 2023, CMS released the calendar year 2024 final rule for services reimbursed under the Medicare Physician Fee Schedule. In...

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Remote Monitoring Services Under Review: Update on Potential Medicare Coverage Policies

By , , , , and on Jul 12, 2023
Posted In Digital Health, Employee Benefits, Health and Welfare Plans

On May 19, 2023, Novitas Solutions and First Coast Options sent an email to certain interested parties, with whom they had engaged following the multijurisdictional contractor advisory committee (CAC) meeting, explaining that they have decided to not pursue at this time a local coverage determination for remote physiological monitoring (RPM) and remote therapeutic monitoring (RTM)....

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Obtaining Payer Coverage for New Tests Continues to Be Difficult

By on Aug 3, 2021
Posted In Employee Benefits, Health and Welfare Plans

Clinical laboratories continue to face challenges to obtain positive coverage decisions by government and private payers for new tests. According to McDermott+Consulting Senior Director Deborah Godes, payers require reasons to establish new coverage assays. “[The] key to getting a positive coverage decision from payers is making a solid case through good quality evidence,” Godes notes...

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