Defining “reasonable & necessary”
This article was originally published in The Gray Sheet
Executive Summary
CMS likely will issue a proposed rule defining the agency's interpretation of its statutory authority to provide coverage, Coverage & Analysis Director Steve Phurrough said Nov. 9 at the Medical Device Manufacturers Association's Reimbursement & Health Policy conference in Washington, D.C. Stakeholders have resisted such a national coverage decision process in the past, he noted (1"The Gray Sheet" May 19, 2006, p. 11)...
You may also be interested in...
NCD Evidence Criteria, Public Participation Are Topics Of Future CMS Regs
CMS does not plan to publish written criteria for assessing whether a service or item is "reasonable and necessary," HHS acknowledges
Japan Grants Global-First Approval To Zolbetuximab, 15 Other New Drugs
Astellas's first-in class CLDN18.2-targeting antibody receives its first approval worldwide, while crovalimab and a number of drugs for rare diseases also receive nods from regulators and are now awaiting reimbursement price-listing.
Hanmi-OCI Merger Hits Wall As Brothers Win Shareholder Vote, Board Seats
The planned merger of Korea's Hanmi Pharm Group with OCI Group hits a major speed bump as the two sons of Hanmi's founder and other candidates recommended by them secture board seats. But it remains to be seen how the Lim brothers will fulfil their ambitious promises.