Category: Reimbursement
Service providers to the medical device manufacturing industry offering reimbursement services.
In an attempt to reduce costs, Minnesota health officials launched an incentive-based payment system for hospitals and ambulatory firms to offer better care.
By Thomas Lee
To improve healthcare in Minnesota, the state is now offering providers a little more than the proverbial pat on the back.
Earlier this month, Minnesota health officials launched an incentive-based payment system for hospitals and ambulatory firms who treat patients enrolled in the state's health insurance programs.
Medicare's FY2011 Inpatient Prospective Payment System (IPPS) proposed rule was released on Medicare's website March 19 and published in the Federal Register (PDF) May 4. The attached worksheet specifies Medicare's proposed FY2011 national average payments for a range of spinal procedures (PDF), effective October 1. Upon close review, you will see:
The Food & Drug Administration says ReGen Biologics Inc. didn't prove the safety of its controversial Menaflex knee implant, ahead of a March 23 panel meeting to re-evaluate the device's 2008 510(k) clearance.
The Food & Drug Administration said ReGen Biologics Inc. (OTC:RGBO) failed to produce adequate evidence that its Menaflex knee implant was safe before it was cleared to hit the market in late 2008.
Documents released by the federal watchdog agency question whether the Hackensack, N.J.-based company supplied enough data on pre-clinical mechanical testing of the device, which is designed to repair damage to the meniscus cartilage in the knee. The documents also question ReGen's claims that the device is similar enough to other devices for shoulder, bladder and hernia repair to merit the FDA's fast-track 510(k) clearance process.
Optimal healthcare reform requires reimbursement models matched to providers' organizational capabilities.
I've recently encountered a number of articles questioning the usefulness of comparative effectiveness research. For example, Keith Winstein, writing in the Wall Street Journal Feb. 10, details the failure of medical practice to adapt to findings from the Courage trial — reported to great acclaim in the New England Journal of Medicine in 2007 — about the relative effectiveness of drug therapy and stenting in relieving chronic chest pain.
Demonstrating clinical evidence is the place to begin ensuring that your new medical technology can win reimbursement.
If "Do you have a code?" is the wrong question to ask when assessing the reimbursement prospects of an innovative device, drug, or diagnostic, is there a right one — a single question that can separate the life science reimbursement gold from the technological base metals that insurers won't likely pay for? Yes there is, and it's a question I don't often hear asked in a clear and concise way:
"Can you demonstrate, with evidence strong enough to withstand rigorous review, predictable clinical benefits to a defined patient population?"
Stated even more simply: "Can you prove your technology's clinical utility?"
The Centers for Medicare and Medicaid Services will cover annual HIV screening for at-risk individuals and pregnant women, hoping to slow the spread of the virus among older populations.
The Centers for Medicare and Medicaid Services shifted gears on its reimbursement policy for both standard and rapid HIV tests, in an attempt to catch more undiagnosed cases in vulnerable populations.
The national insurer changing a statute to make it easier for people whose behavior puts them at greater risk of contracting the virus to get annual screening.
CMS said it will now reimburse physicians for annual HIV screening for the following populations:
- Men who have had sex with men after 1975;
- Men and women having unprotected sex with multiple partners;
- Past or present injection drug users;
The Boston Healthcare Associates reimbursement expert dishes on the healthcare reform push and how it will affect medical device makers, ahead of his keynote speech at the MassMEDIC 11th Annual Medtech Investors Conference.
Charles Mathews is no stranger to Capital Hill, having worked as a legislative aide to Reps. David Price (D-N.C.) and Rob Andrews (D-N.J) in the early years of the decade. That experience comes in handy in his role a director at Boston Healthcare Associates, where he's keeping tabs on the ever-evolving debate over healthcare reform in Washington.