Olympus says CMS recently took a significant step forward to boost colorectal cancer care in the U.S. CMS, on Nov. 1, announced that it will eliminate Medicare cost-sharing for a follow-up colonoscopy after an at-home stool test returns a positive result. Defining such colonoscopies as preventative services means that Medicare beneficiaries will no longer have […]
Reimbursement
Rewalk Robotics seeks reimbursement wins
Rewalk Robotics (Nasdaq: RWLK) today reported its third-quarter revenues were half what they were a year before, with losses widening. However, the robotic exoskeletons company is seeking to advance its technology through reimbursement wins in the U.S. and Germany. Early this month, Rewalk submitted its first case to Medicare Administrative Contractors (MACs) for coverage and […]
Nevro wins multiple coverage options for spinal cord stimulation
Nevro (NYSE:NVRO) today announced positive updates to multiple spinal cord stimulation (SCS) coverage policies. Aetna’s new SCS policy explicitly covers PDN (painful diabetic neuropathy), effective Aug. 29, 2022. Aetna’s health plan covers approximately 22 million commercial lives. Novitas and First Coast, Medicare Administrative Contractors (MACs) that represent 12 states, also provided a positive update. They […]
iRhythm stock up on positive news out of CMS
iRhythm Technologies (Nasdaq:IRTC) stock soared today on positive reimbursement news out of CMS as the agency makes 2023 fee schedule proposals. Truist analysts yesterday evening pointed to CMS proposing a national coverage determination (NCD) of $229 for the ZioXT wearable cardiac monitor. When incorporating the geographic physician payment adjustments, the analysts thought the actual payment […]
Analysts say high payor coverage, increased CGM adoption bodes well for Abbott, Dexcom
Analysts have suggested that companies like Abbott (NYSE:ABT) and Dexcom (Nasdaq:DXCM) may benefit from expected reimbursement progress. BTIG hosted a conference call with North Shore Medical Center (Salem, Massachusetts) Medical Director Dr. Gary Cohen and Healthcare Analytics, LLC analyst and consultant Dr. Joshua Cohen. The two experts offered insights into prescriber and patient interest in continuous glucose monitors (CGMs) […]
Japan approves expanded reimbursement coverage for Abbott’s FreeStyle Libre CGM
Abbott (NYSE:ABT) announced today that it received expanded reimbursement coverage in Japan for the FreeStyle Libre system. Japan’s Ministry of Health, Labour and Welfare approved the expansion for the continuous glucose monitoring (CGM) system to include all people with diabetes who use insulin at least once per day. Get the full story at our sister site, […]
Inspire Medical Systems says reimbursement questions cleared up at CMS
Inspire Medical Systems (NYSE: INSP) says CMS has answered some questions about how it will reimburse its implantable sleep apnea treatment device. The Golden Valley, Minnesota–based company announced on November 10 that CMS has published updated addendum files for the 2022 ambulatory surgery center payment system. The update included an assigned device offset percentage and […]
CMS extends joint replacement pricing by 3 years
The Centers for Medicare and Medicaid Services (CMS) has extended bundled pricing for hip and knee replacements for three years. The final rule, published in the Federal Register, extends the “Comprehensive Care for Joint Replacement” cost-bundling program through Dec. 21, 2024. The cost-cutting program began in January 2016, when CMS required all hospitals in 67 geographic […]
CMS delays shift to new payment model for chronic kidney disease treatments
CMS will now wait until Jan. 1, 2022 to start its Kidney Care Choices model, meant to shift the way the U.S. treats chronic kidney disease. The new payment model was supposed to start on Jan. 1 of this year, but health providers are still grappling with the COVID-19 pandemic. The new model could have […]
Medical Alley Association asks CMS to make it easier for breakthrough devices to win coverage
Medtech receiving a breakthrough device designation from FDA should be able to satisfy all of CMS’s non-cost criteria for transitional pass-through payments, according to the Medical Alley Association. The Minnesota-based trade group’s CEO Shaye Mandle made the proposal in comments submitted Sept. 24 in response to a proposed rule from CMS to revise the Medicare […]
Myomo lands Medicare coverage
Myomo (NYSE:MYO) announced that it received authorization to be a Medicare provider through the Centers for Medicare & Medicaid Services. CMS, under the U.S. Dept. of Health and Human Services, now includes Cambridge, Mass.-based Myomo in its Medicare Supplier Directory at Medicare.gov, which enables Myomo to bill Medicare directly when it delivers its MyoPro orthosis in […]
