HCFA Expected To Offer Compromise On Cost In Proposed Coverage Criteria
This article was originally published in The Gray Sheet
Executive Summary
HCFA plans to eliminate or significantly scale back the role of cost from its proposed criteria for making Medicare coverage decisions, according to agency staff.
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Medicare coverage criteria
Town hall meeting originally planned for Aug. 31 to discuss the agency's May 16 "notice of intent" on coverage criteria is rescheduled for Sept. 13. HCFA plans to issue a Federal Register notice the week of Aug. 28 rescinding the earlier date. Issues to be addressed at the town hall meeting include increased evidence burden in coverage reviews and withdrawal of coverage for older technologies. The agency also is expected to announce that it will handle cost issues through its payment division, rather than as part of coverage decisions (1"The Gray Sheet" Aug. 21, 2000, p. 6)
Medicare coverage criteria
Town hall meeting originally planned for Aug. 31 to discuss the agency's May 16 "notice of intent" on coverage criteria is rescheduled for Sept. 13. HCFA plans to issue a Federal Register notice the week of Aug. 28 rescinding the earlier date. Issues to be addressed at the town hall meeting include increased evidence burden in coverage reviews and withdrawal of coverage for older technologies. The agency also is expected to announce that it will handle cost issues through its payment division, rather than as part of coverage decisions (1"The Gray Sheet" Aug. 21, 2000, p. 6)
HCFA Coverage Criteria Notice Criticized By Competing Interest Groups
The Health Care Financing Administration's proposal for Medicare coverage criteria would lower the evidentiary standards for new medical technologies seeking reimbursement, according to the Blue Cross/Blue Shield Association.