Alere (NYSE:ALR) yesterday said that it’s suing to force the Centers for Medicare & Medicaid Services to reinstate its Arriva diabetes division’s enrollment, after the government health insurer yanked the accreditation last month over issues with an excess of claims submissions for deceased patients. Arriva, which develops durable medical equipment for diabetic testing, was informed Oct. 12 that […]
Reimbursement
Japan approves Medtronic’s CoreValve Evolut R heart valve
Medtronic (NYSE:MDT) said today that it won reimbursement and Shonin approval from the Japanese Ministry of Health, Labor & Welfare (MHLW) for its CoreValve Evolut R transcatheter aortic valve replacement. Fridley, Minn.-based Medtronic, which won pre-market approval from the FDA for the CoreValve Evolut R in June 2015, said the Japanese approvals include its Enveo R delivery system. […]
New Medicare rules pay docs based on outcomes
The White House last week changed the way government health insurers pay doctors, shifting from the fee-for-service model in favor of an outcomes-based system. The so-called “doc fix” law, passed by Congress in 2015, was drafted in March 2015 by then-House speaker Rep. John Boehner (R-Ohio) and minority leader Rep. Nancy Pelosi (D-Calif.) in rare moment of bipartisanship. The Senate voted […]
Gore wins Medicare add-on status for Excluder stent graft
W.L. Gore & Assoc. said today that it won new technology status from the U.S. Centers for Medicare & Medicaid Services for its Gore Excluder iliac branch endoprosthesis. Set to go into effect Oct. 1, the change will allow facilities that use the device, in conjunction with Gore’s Excluder AAA device for endovascular aneurysm repair, to be eligible […]
Silk Road Medical touts Medicare coverage decision for carotid procedures
Silk Road Medical said yesterday that the Centers for Medicare & Medicaid Services granted coverage for transcarotid artery revascularization procedures, including those performed with its Enroute transcarotid neuroprotection and stent system. The TCAR procedures are now eligible for coverage for patients who are treated with FDA-approved proximal embolic protection devices and approved carotid artery stent systems […]
Intersect ENT claims reimbursement win for Propel drug-eluting sinus implant
Intersect ENT (NSDQ:XENT) said today that it won a positive coverage decision from CareFirst BlueCross BlueShield for its Propel and Propel Mini drug-eluting sinus implants. The devices are designed to elute the anti-inflammatory steroid mometasone furoate; Menlo Park, Calif.-based Intersect won FDA approval for the original Propel implant in August 2011 and for the Propel Mini the following September. The […]
Cigna adds reimbursement coverage for 3D breast scans
Cigna (NYSE:CI) said this week that it’s revising its coverage to include 3D mammography for routine breast cancer screening. The Bloomfield, Conn.-based health insurer only reimbursed for 3D breast scans made for diagnosis, based on the U.S. Preventive Services Task Force’s finding that there’s not enough data to show that 3D mammography is better than traditional mammography in […]
NeoTract logs reimbursement wins for UroLift prostate treatment
NeoTract said today that it logged several reimbursement wins for its UroLift treatment for enlarged prostates, including a Medicare contractor and at least 7 independent insurers. The UroLift system for benign prostate hyperplasia uses tiny devices that are inserted into the urethra in a minimally invasive procedure to reopen the lower urinary tract by pushing aside tissue from the […]
Boston Scientific logs Pa. reimbursement win for Alair asthma treatment
A private insurer in Pennsylvania is the latest to cover the Alair asthma treatment from Boston Scientific (NYSE:BSX). Philadelphia-based Independence Blue Cross said June 24 that it will cover the Alair bronchial thermoplasty treatment, which is designed to use thermal energy to reduce smooth tissue in the lungs to decrease the airways’ ability to constrict. Boston Scientific added […]
Nevro takes a hit after insurers deem Senza therapy experimental
Shares in Nevro (NYSE:NVRO) took a hit yesterday after investors learned that a pair of insurers in Pennsylvania and Tennessee tagged therapy using its Senza spinal cord stimulation device as experimental. The Senza device, which won an FDA nod in May 2015, is designed to deliver high-frequency electrical impulses of up to 10,000Hz to the spinal cord to avoid the […]
Hospitals to pony up $28m for false kyphoplasty claims
The U.S. Justice Dept. said today that a group of 32 hospitals agreed to pony up a collective $28 million to settle charges that they billed Medicare at the inpatient rate for outpatient kyphoplasty procedures. In kyphoplasty, a treatment for vertebral compression fractures from osteoporosis, surgeons create a void within the vertebra and fill it […]