OFFICE OF RESEARCH AND DEVELOPMENT (ORD)

Office of Research and Development

Office of Research and Development
The Queen’s Medical Center
1301 Punchbowl Street, UHT 508
Honolulu, HI 96813

Medicare Coverage Analysis

MCA Submission

All new clinical studies will start at the MCA Request regardless of funding sources (ie. Extramural industry or private funding, extramural non-profit or government funding, and/or intramural funding).  This includes investigator-initiated, cooperative group, industry, and federal studies. It will then be determined whether an MCA/CA, Calendar only or Study Shell will be required.

Requesting a MCA build

The starting point begins with serious consideration of a study.

1. Send an email to the following recipients: jvillasin@queens.org

2. Include the following in the Subject of the email:

  • MCA Request: [Short Name of Study] [PI]
  • Example: “MCA Request: CSTUDY Doe

3. Fill out ONE of the following form and attach to the email:

4. Provide the following soft copy documents as attachments for the applicable study types:

NCI/Cooperative group studies Pharma/Industry (including Registry/Data Collection type) Investigator-initiated Other
Protocol
Protocol
Protocol
Protocol
ICF*
ICF*
ICF*
ICF*
Funding Sheet
Prelim budget
Prelim budget
Prelim budget
NCA** (if there is one)
Prelim contract
Prelim contract
Investigator’s Brochure
Investigator’s Brochure
Investigator’s Brochure
Device Instructions for Use
Device Instructions for Use
Device Instructions for Use
Lab Manual – mandatory for phase 1 studies
Lab Manual – mandatory for phase 1 studies
Case Report Forms
Case Report Forms
Pharmacy Manual
FDA IDE Letter (Device)
CMS Category Letter (Device)

* Make note whether the consent is a template or the proposed version for QMC

** NCAs (National Coverage Analysis) are provided for certain Oncology Cooperative Group studies from NCI.  It is expected that each institution reviews the NCA and make any modifications that are justified to create an institution MCA.

MCA OR STUDY SHELL COMPLETION

  1. If it is determined that a Study Shell only is required, an entry will be made in Clinical Conductor with the RA number. Final IRB approved documents (eg protocol and ICF) should be provided. Any changes to the study should be notified to Jeremiah.
  2. If it is determined that an MCA is required, then an MCA will be built on an Excel file within 10 business days and will be provided to the Study Coordinator for review, feedback and edits.
  3. Once finalized, the MCA will be provided to the Research Business Office (RBO) or Sponsored Program Office (SPO) for budget negotiations, if necessary

CALENDAR BUILD PROCESS AND COMPLETION

  1. Studies may proceed to Budget Process and Calendar Build where sponsor says for all and no procedures are billed to Insurance/Patient.
  2. Once the budget is finalized, the study calendar will be built in Clinical Conductor
  3. The calendar will be provided to the Study Coordinator within 10 business days for review, feedback and edits in the format of an excel file.
  4. Changes to the MCA/Study Calendar can be made after budget negotiations.

QUESTIONS/CONCERNS:

Contact Jeremiah Villasin at 808-691-4645 or jvillasin@queens.org

or

Rebecca Ohta at 808-691-4106 or rohta@queens.org