Pricing & Reimbursement

ARTICLES

India Sets Price Controls for Knee Implants

Health authorities in India have imposed price caps on orthopedic knee implants. Read More

GAO Says Disposable Devices Should Be Covered by Medicare

The Government Accountability Office wants the Centers for Medicare & Medicaid Services to consider allowing the use of disposable medical devices in some situations where durable devices had only been covered by Medicare. Read More

India Warns Stent Makers to Supply Products Despite Price Controls

India’s National Pharmaceutical Pricing Authority says coronary stent manufacturers must continue supplying all brands of stents they supplied before price controls went into effect on Feb. 14. Read More

Experts Outline Steps to Maximize Device Reimbursement

If reimbursement is already available for a predicate device, a 510(k) clearance is most appropriate, because it is faster and more predictable, although it limits the potential for higher payment. Read More

Mylan Reaches $465M Settlement on EpiPen Misclassification Charges

Mylan will pay $465 million to settle claims that the company misclassified its epinephrine auto-injector EpiPen for the Medicaid Drug Rebate program, allowing it to pay lower reimbursement rate to states for almost a decade. Read More

Indian Regulator Demands Information on Stent Pricing

Indian authorities are asking manufacturers of cardiac and drug-eluting stents to explain why they haven’t provided the government with information on pricing and availability of their products, as requested in early December. Read More

CMS to Cover Low-Dose CT Screening in Heavy Smokers

The U.S. Centers for Medicare & Medicaid Services has agreed to cover low-dose computed tomography for annual lung cancer screening in certain Medicare beneficiaries. Read More

Industry Urging Japan to Address Reimbursement

Japan could stimulate more foreign direct investment and a more robust domestic medical technology industry if it switched to a market-based reimbursement system, says U.S. industry group AdvaMed. Read More

Industry: U.S. Implementation of ICD-10 Should Stay on Track

Devicemakers are urging the U.S. Congress not to delay ICD-10 implementation again, saying the new diagnostic codes are more precise and will allow healthcare providers to better track patient outcomes — resulting in savings for the Medicare payment program. Read More

Expert: Optimize Trials as CMS Coverage Narrows

The U.S. Centers for Medicare & Medicaid Services increasingly wants to see evidence of positive outcomes before it will cover a medical product, according to a new study that found recent coverage determinations 20 times less likely to be positive than in the past. Read More