Biden abolishes Trump-era health insurance “breakthrough” coverage policy


Center for Medicare and Medicaid Services final decision Repeal a rule that will create a fast path to medical insurance coverage for medical devices deemed “breakthrough technology.”

Once authorized by the market, the rule will allow medical insurance to cover devices deemed “breakthrough” by the Food and Drug Administration for four years. But Biden CMS is worried that this will lead to the coverage of equipment without evidence, especially since they can adequately provide services to medical insurance beneficiaries.

Lee Fleisher, Chief Medical Officer of CMS, said in a press release: “Under the rules we are repealing, CMS may cover cases where there is insufficient evidence to prove that the device is reasonable and necessary for diagnosing or treating specific medical conditions in Medicare populations. equipment.” .

After CMS again postponed its implementation in March and May, it proposed to abolish the rule in September. If there is no final rule on Friday, the policy will take effect in December.

The final rule says that CMS still hopes to improve access to breakthrough technologies, and may do so through existing channels or future rulemaking.



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