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New FDA Guidance for Long-standing Deferral; HIV Changes
The Food and Drug Administration issued new guidance on blood donations, removing some long-standing deferrals. In addition to this, the FDA is also considering moving towards an individualized risk-based approach when deciding donor eligibility. These changes are related to HIV medications and those at risk for contracting HIV.
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TRICARE uses the reimbursement rates established by the Centers for Medicare and Medicaid Services (CMS) for certain items and services of Durable Equipment (DE), Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Parenteral and Enteral Nutrition (PEN).
Please visit the CMS DMEPOS Fee Schedule to access DMEPOS and PEN reimbursement rates for certain items and services that begin with a HCPCS code of A, B, E, K, L, Q, or V. (Link will open in a new browser window.)
For all other items of DMEPOS, TRICARE pays a maximum allowable charge. For further information, please contact your regional contractor or see the following TRICARE Reimbursement Manual references:
For more information refer to the TRICARE Reimbursement Manual, Chapter 1, Section 11 and the Notice (85 FR 85613) published at:
https://www.federalregister.gov/documents/2020/12/29/2020-28762/tricare-proposed-rates-for-reimbursing-durable-medical-equipment-prosthetics-orthotics-and-supplies
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