AHIP raises concerns over Medicare innovation, ‘reasonable and necessary’ rule

America’s Health Insurance Plans submitted comments to CMS Administrator Chiquita Brooks-LaSure on Oct. 12 over the organization’s Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” rule. 

Advertisement

CMS opened public comment on the final rule, which was published in January but received significant criticism.

In AHIP’s comment, the organization raised concerns about the innovative technology rule’s pathway process, which it said fails to fully “evaluate safety, efficacy, and value” of technologies. It also cited operational issues, such as when and how CMS should communicate appropriate information with constituents.

AHIP also took issue with the definition of “reasonable and necessary,” which it said removes existing flexibilities. The organization encouraged CMS to continue to bring stakeholders to the table as it discusses changes. 

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.