Healthcare DIVE February 15, 2023
Dive Brief:
- Boston Scientific and the Medical Device Manufacturers Association want regulators to take more steps to ensure Medicare Advantage plans are consistent in their coverage decisions.
- Medicare Advantage plans, which are offered by private insurers that follow rules set by Medicare, can develop coverage criteria in the absence of applicable national and local coverage determinations. The medtech industry has criticized the transparency of the plans.
- Boston Scientific said in a letter that Medicare Advantage plans “do not often provide a clear reason for the denial of coverage, and rarely offer any visibility into the evidence and methodology” and urged the CMS to “consider policies that require greater transparency.”
Dive Insight:
Late last year, the CMS published a...
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