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. 

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.