Reimbursement

MDMA continues to work with the Centers for Medicare and Medicaid Services (CMS) and Congress to ensure that medical devices are reimbursed at adequate levels. Unfortunately, coverage, coding, and payment processes remain a difficult challenge that manufacturers have to surmount.

MDMA believes that immediate action is needed to ensure that Medicare reimbursement rates accurately reflect hospitals' true cost of performing procedures that utilize innovative medical devices. We have urged CMS to utilize (and hold confidential) third party data submitted by manufacturers, physicians, and hospitals to develop more accurate estimates of device acquisition costs and to use those estimates to develop new rates. We also have worked with Congress to advance legislative proposals that would ease the path to market for new devices, including preservation of a strong local coverage process, more adequate payments for new inpatient and outpatient technologies, and coverage for clinical trials. In meeting with legislators and their staffs or drafting comments to CMS, MDMA seeks to ensure that patients have access to the best and latest innovative products and to ensure that Medicare fosters innovation, rather than stifles it.

In addition to our advocacy efforts, we serve as a reliable source of information for our membership on reimbursement issues. We continue to hold our Annual Reimbursement and Health Policy conferences, which are widely attended. In addition, with regularly scheduled email updates and monthly conference calls specific to Medicare, we provide members with legislative and regulatory updates. We encourage a two-way flow of information, and most of our policy initiatives are concerns that have been brought to us by individual members.

What is MDMA doing?

MDMA assists its members' efforts to improve the health of Medicare beneficiaries by facilitating the introduction of safe and effective medical technologies into clinical practice. By working with the Centers for Medicare and Medicaid Services (CMS) and Congress, we have made significant progress over the past several years - such as achieving positive improvements in coverage for clinical trials, payment for new technologies, and stabilizing reimbursement for critical devices under the hospital outpatient prospective payment system. We also have worked with lawmakers to advance legislative proposals that would ease the path to market for new devices, including preservation of a strong local coverage process.