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 recently held our tenth annual Coverage & Reimbursement Conference in Washington, D.C., which was well attended and received rave reviews. 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. Finally, MDMA is dedicated to the adoption and implementation of the International Classification of Diseases (ICD) 10th edition coding system by the year 2010.
NEWS
MedPAC Agrees with MDMA to Implement Short-Term Fix for Charge Compression
June 19, 2008 - As part of MedPAC’s comment letter to CMS regarding the proposed inpatient prospective payment system (IPPS) rule, the advisory committee agreed with MDMA and other device stakeholders that CMS should implement a short-term fix to address the problems associated with charge compression. MedPAC specifically cited the use of a regression-based approach, as suggested in the 2007 RTI report commissioned by CMS, as the most appropriate approach to ensure adequate and timely payments for implantable devices.
MedPAC’s comment letter 
MDMA Submits Comments on Proposed IPPS Rule
June 13, 2008 - MDMA submitted comments last week on the proposed Medicare Inpatient Prospective Payment System (IPPS) rule. In the rule, CMS addressed two key areas of concern for device manufacturers: charge compression and new technology add-on payments. MDMA commended CMS for addressing the issue of charge compression, whereby CMS proposes to create a separate cost center to dampen the price distortion caused by grouping higher cost devices with lower cost items. MDMA also urged CMS to take action to immediately address the problems associated with price distortion caused by charge compression. In addition, MDMA also commended CMS for taking positive steps in bringing greater clarity to the new technology add-on payment process.
MDMA’s comment letter 
CMS Releases Proposed Inpatient Rule
April 14, 2008 - The Centers for Medicare and Medicaid Services (CMS) released the proposed hospital Inpatient Prospective Payment System (“IPPS”) rule. As expected, CMS addressed several areas of concern to the medical device industry including, but not limited to, charge compression, new technology add-on payments, physician owned medical device companies and gainsharing.
CMS also address several other areas of general concern. CMS estimates that payments to acute hospitals will increase by $4 billion in the next fiscal year. In addition, CMS projects that hospitals that report all of the required quality measures will receive a full market basket update of 3% while non-reporting hospitals will receive an update of only 1%. CMS will also complete the three-year phase-in of cost-based weights and the two-year phase-in of Medicare Severity Diagnosis Related Groups (MS-DRGs).
MDMA will continue to follow developments with the proposed IPPS rule and will submit comments to CMS accordingly.
More information on the rule
MDMA Presents Comments to the CMS APC Panel
March 7, 2008 -
This week, the Centers for Medicare and Medicaid Services (CMS) Advisory Panel on APC payments held its semi-annual meeting in Baltimore. MDMA presented comments to the Panel again urging them to reexamine the current CMS packaging efforts as well as to encourage CMS to continue with its rate-setting methodology for device-dependent APCs. As a result of MDMA’s testimony, the Panel unanimously voted to recommend to CMS that the Agency study effectiveness of the packaging methodology over the course the next year.
MDMA’s Comment Letter to CMS 
MDMA Presents Comments at CMS New-Technology Town Hall Meeting
February 22, 2008 - MDMA presented comments this week at the Centers for Medicare and Medicaid Services new-technology Town Hall meeting. The meeting was an opportunity for manufacturers and stakeholders to present comment on emerging technologies. MDMA stressed several points during the meeting including the difficulty many small manufacturers are increasingly facing in attempting to qualify for a new-technology.
MDMA’s complete comments 
CMS Town Hall Meeting for New Medical Services and Technologies Add-on Payments
January 11, 2008 - CMS will hold a Town Hall meeting to discuss fiscal year (FY) 2009 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system. The meeting is scheduled for Thursday, February 21, 2008 and will be held at CMS Headquarters in Baltimore, MD. Comments for the meeting are due on Thursday, February 7, 2008.
MDMA will be submitting comments to CMS and will encourage CMS to appropriate reimbursement for new, innovative and life-saving medical technologies.
More information can be found on the CMS website:
http://www.cms.hhs.gov/AcuteInpatientPPS/08_newtech.asp
Archived Reimbursement News