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BioWorld - Sunday, December 14, 2025
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Medicare puzzle

MITA, surgeons pushing back against Medicare physician fee draft for 2021

Aug. 10, 2020
By Mark McCarty
The annual publication of the draft Medicare physician fee schedule (MPFS) is an event, but this year’s draft has drawn substantial criticism from across the board, despite the promise of more coverage of telehealth. The Medical Imaging & Technology Association (MITA) and a coalition of surgeons have blasted the draft as a hazard to patient access to both evaluation and management (E/M) services and surgical procedures, both of which present substantial headwinds for the medical device industry.
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Coronavirus vs U.S. wrecking balls

Harvard’s Mina says ‘archaic view’ of testing impeding cheap surveillance testing for COVID-19

Aug. 7, 2020
By Mark McCarty
The COVID-19 pandemic has sparked some innovation in testing, but not all that innovation has made it to market. Michael Mina, an assistant professor of epidemiology at the Chan School of Public Health at Harvard University, said on an Aug. 7 conference call that the U.S. FDA’s “archaic view” of testing is impeding the use of paper strip tests he said would turn the tide in the effort to contain the pandemic.
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Health professional pointing stethoscope at Clinical Trial words, icons

Aronson says validated outcome measures are desperately needed for clinical evidence

Aug. 6, 2020
By Mark McCarty
Real-world evidence (RWE) and clinical trial data might seem to bear little resemblance to each other, but Naomi Aronson, executive director for clinical evaluation at the Blue Cross and Blue Shield Association, said there are problems common to both. The most significant of these is an absence of validated outcomes measures for many conditions, measures Aronson said are “desperately” needed in order to make an appropriate coverage determination.
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U.S. White House

White House moves on telehealth executive order to counter rural hospital closure

Aug. 4, 2020
By Mark McCarty
The Trump administration has issued an executive order designed to improve access to telehealth for Medicare beneficiaries in rural America, making permanent numerous changes that had been temporarily added for the COVID-19 pandemic. The news arrives as the Centers for Medicare and Medicaid Services (CMS) posted the draft Medicare physician fee schedule (MPFS) complete with expanded use of telehealth for a number of services.
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Telehealth illustration

Support for telehealth growing, but privacy still a sticking point

July 13, 2020
By Mark McCarty
If there’s a readily visible upside to the COVID-19 pandemic, it may be that telehealth is not only much more accessible, it’s also supremely topical among policymakers. However, privacy concerns are still a significant source of drag in some respects, a consideration that extends to digital medicine as well in the context of contact tracing used to corral the SARS-CoV-2 virus.
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Product image

COVID-19, BLM push diabetes equity, access issues as experts assess tech use after ADA

July 7, 2020
By Stacy Lawrence
After the recent conclusion of the American Diabetes Association (ADA) Scientific Sessions, virtual diabetes management company Onduo LLC held an event with the ADA and diabetes researchers to discuss how technology can help to bridge that gap to empower more diabetes patients.
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Product image

CMS steers closer to coverage of secondary mitral regurgitation in draft coverage rewrite

July 1, 2020
By Mark McCarty
The U.S. Centers for Medicare and Medicaid Services (CMS) posted the much-anticipated draft do-over of the mitral valve repair device coverage memo, and in the process renamed the policy the mitral valve transcatheter edge-to-edge repair (TEER) national coverage memo.
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CMS begins to tear down the wall to value-based Rx pricing

June 18, 2020
By Mari Serebrov
After 30 years of following the same rules to ensure Medicaid receives the lowest price available for prescription drugs, the U.S. Centers for Medicare & Medicaid Services (CMS) is starting to adapt those rules for the 21st century.
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Medicare puzzle

NTAP eligibility for Sentinel, Aquabeam devices set to expire for Medicare NTAP program

May 29, 2020
By Mark McCarty
The Medicare inpatient draft is always an event due to its impact on medical technology. Now, several products soon may see their new technology add-on payments (NTAP) expire because of eligibility. The Centers for Medicare and Medicaid Services (CMS) said both Claret Medical Inc.’s Sentinel embolic protection device and Procept Biorobotics Corp.’s Aquabeam device have used up their NTAP eligibility, and hospitals may see lower rates for using those devices starting Oct. 1
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Drugs-insulin2

Manufacturers to foot much of the bill for Medicare insulin savings

May 26, 2020
By Mari Serebrov
Unpredictable and unaffordable copays for insulin could be a thing of the past for millions of people enrolled in certain Medicare Part D prescription drug plans.
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