CMS To Boost Medicare New Tech Add-On Payments To 65% – But Industry Wants More
Industry groups AdvaMed and the Medical Device Manufacturers Association (MDMA) thanked the US Medicare agency CMS for its recent proposal to allow coverage for new breakthrough devices. But both said a CMS proposal for new technology add-on payments in fiscal year 2020 Inpatient Prospective Payment System (IPPS) rules to boost rates for new devices from 50% to 65%, should actually be an 80% increase.
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The US Medicare agency revised and clarified its policies on how it evaluates new technology add-on payments and highlighted its new policy on payments for FDA-approved breakthrough devices, in a final 2020 Inpatient Prospective Payment System (IPPS) rule released on 5 August.
A new proposed rule would give automatic new technology add-on payments to breakthrough devices. While it may affect only a very small sector of the industry, the lobby group AdvaMed says it is a good first step to getting broader coverage for all devices and will incentivize companies to invest in breakthrough device research.
The US Centers for Medicare and Medicaid Services plans to automatically allow reimbursement and up to 65% new technology add-on payments for US FDA-approved, -cleared or de novo devices in the agency's Breakthrough Devices Program. Industry groups, including the Medical Device Manufacturers Association and AdvaMed, have been pushing CMS for such coverage for several years.