Predictability of insurance coverage procedures and market expansion repricing

Committee:
Medical Equipment
status:
Some progress
Published:
Some progress has been seen regarding referrals to the Medical Technology Evaluation Subcommittee, under which requested insurance coverage details are deliberated by that subcommittee. In addition, the request to set the period of evaluative medical care on the assumption of insurance coverage at the revision following the most recent medical fee revision was approved. Partial progress was also made regarding market expansion repricing for devices covered under technical fees and for in vitro diagnostics.

Recommendations

  • Clarify the scope, calculation methods and treatment of costs related to medical devices, etc. in market expansion repricing, giving due consideration to the impact on patient access and continued supply.