Medicare Looks Harder Before Reimbursing Devices
Medical device manufacturers are finding Medicare more demanding before the administration accepts to put new products on its reimbursement lists. For the past two years the administration has refused reimbursement requests for products such as a new wheelchair cushion from Otto Bock Healthcare, Johnson & Johnson’s artificial spine disk and Medtronic’s continuous glucose monitor for diabetics. Steve Phurrough, Director of the Coverage and Analysis Group within the CMS, was quoted by Bloomberg as saying: “Should we pay for anything that any physician wants to provide to any patient? I think the answer to that is no.”
German manufacturer Otto Bock for instance claims it stuck to the procedures that would have ensured approval in the past for its cushion, but Medicare then requested very expensive randomized clinical trials to justify that the product’s benefits would make it worth being reimbursed. Phurrough said the agency indeed wants more evidence to base its reimbursement decisions on. Patrick Chelf, a vice president at Otto Bock’s American subsidiary, expressed concern that this policy would prevent smaller manufacturers to take products to market.
June 5, 2006 Related topics: Evaluation & assessment, Cost savings