Globus Medical (NYSE:GMED) last week said it won a coverage decision for its Secure-C cervical spine implant from health insurance giant Anthem (NYSE:ANTM). Audubon, Pa.-based Globus said the decision means the device is covered by the major third-party payers in all 50 states. Anthem has more than 73 million lives under its coverage umbrella, according to Globus. The Secure-C […]
Inspire Medical Systems scores win with Blue Cross Blue Shield Association
Inspire Medical Systems – creator of a pacemaker-like system to treat obstructive sleep apnea – said today that the Blue Cross Blue Shield Association’s Evidence Street issued a positive assessment of Inspire therapy to its members. BCBSA is a national federation of 36 Blue Cross and Blue Shield companies. The report from BCBSA, according to Inspire […]
3 ways HHS can help medtech innovators
The U.S. Department of Health and Human Services (HHS) is doing everything from sharing more data to cultivating entrepreneurial talent and engaging in partnerships in order to support medical device innovators, the department’s CTO Ed Simcox told than 100 industry insiders in the Twin Cities today. A major goal at HHS is to build an innovation-focused […]
Hospitals saved money under Medicare bundled-payment program
Medicare payments for lower extremity joint replacement care fell by 3.3% among participating hospitals compared to a control group in the first year of a bundled payment pilot program, according to the Centers for Medicare & Medicaid Services (CMS). Quality of care was maintained in both settings, the federal health insurer said. CMS required all hospitals […]
Abbott wins Aetna nod for Proclaim neurostim in chronic pain
Abbott (NYSE:ABT) said today that it won a reimbursement nod from Aetna (NYSE:AET) for its Proclaim dorsal root ganglion neurostimulation therapy for treating chronic pain. The national coverage decision opens DRG treatment to some 22 million Aetna members, Abbott said. Aetna already covers treatment with Abbott’s spinal cord stimulation devices, the company said. It acquired […]
Medical device startups: Here’s how you handle regulatory and reimbursement
The two “Rs” — regulatory and reimbursement — are critical elements of the environment in which a medical device product is developed. Bill Betten, Betten Systems Solutions This is the fourth in a series of articles that discusses the design of innovative products in the highly regulated medical environment. But the “environmental” factors of regulatory and reimbursement actually […]
Medical device reimbursement: How it’s a brave new world
Populations in developing countries are aging. Healthcare systems are feeling even more financial pressure. In response, there’s been a shift toward payment models in the U.S. and elsewhere that emphasize “value.” In other words, health providers need to run more efficiently and effectively to get paid. Medical device reimbursement will never be the same. “This […]
Abbott wins Japanese reimbursement nod for MitraClip
Abbott (NYSE:ABT) said today that it logged a reimbursement win in Japan for its MitraClip device for treating mitral valve regurgitation. The Chicago-area medtech giant said Japan’s Ministry of Health, Labor & Welfare granted national reimbursement for MitraClip, effective April 1. The MHLW approved the device last November for treating severe degenerative mitral regurgitation functional mitral regurgitation. […]
Medicare finalizes cuts to value-based healthcare programs
The Centers for Medicare & Medicaid Services yesterday finalized cuts to a trio of bundled payment pilot programs aimed at lowering healthcare costs and improving outcomes. The federal health insurer cut the Comprehensive Care for Joint Replacement Model, or CJR, effectively in half, from 67 geographic areas participating to 34, meaning about 470 hospital participants instead of 800. […]
Medicare expands reimbursement for EndoGastric Solutions EsophyX device
EndoGastric Solutions said today that a Center for Medicare & Medicaid Services administrator granted reimbursement coverage for its EsophyX device for treating gastroesophageal reflux. National Government Services extended coverage for transoral incisionless fundoplication using the EsophyX device to some 9.3 million patients in Connecticut, Illinois, Maine, Massachusetts, Minnesota, New Hampshire, New York, Rhode Island, Vermont and Wisconsin effective Dec. […]
Should the medical device industry pay user fees to CMS?
Achieving reimbursement from payers has become a major challenge for medical device companies. Could the solution lie in having them pay user fees to CMS – the way they do to FDA? That was the question floated by Nadim Yared, president of CVRx and the current chairman of AdvaMed, during this week’s Medtech Conference powered by […]
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