HIMA Supports Ramstad's Legislation to Integrate Medical Technology into the Medicare System

FOR IMMEDIATE RELEASE
June 8, 1999 CONTACT:Karen Alcorn
(202) 434-7240
Linda Ruckel
(202) 434-7243

HIMA SUPPORTS RAMSTAD'S LEGISLATION TO INTEGRATE MEDICAL TECHNOLOGY INTO THE MEDICARE SYSTEM

WASHINGTON, D.C.--The Health Industry Manufacturers Association (HIMA) applauds Representative Jim Ramstad's (R-MN) legislation to reform Medicare's payment and coding systems in order to keep pace with advances in medical practice and to better integrate medical technologies into the Medicare program. "The Medicare Patient Access to Technology Act of 1999," introduced last night by Ramstad would require the Health Care Financing Administration (HCFA), which administers Medicare, to adjust and update more frequently Medicare's payment and coding systems so that Medicare beneficiaries receive timely access to medical technologies.
"This legislation will help shorten the time it takes for medical products and therapies to reach the nearly 40 million Medicare patients both today and in the future," said David Fleming, group senior vice president of Genzyme Corporation and chairman of the HIMA Board of Directors' Payment and Health Care Delivery Committee.
Many medical technologies reach patients only after they have cleared the lengthy product review process at the Food and Drug Administration (FDA) and have overcome three lengthy, separate and distinct procedural hurdles within the Medicare program. Technologies must be "covered" by Medicare; they must be assigned an identifying procedure code; and finally, Medicare must place technologies into one of its reimbursement systems that apply to care provided by hospitals, physicians, skilled nursing facilities, and other providers. "A problem at any of these three stages can delay or stop a technology from reaching Medicare patients," said Fleming. "Unfortunately, some technologies which overcome one hurdle then become entangled in the next." In late April, HCFA published a notice in the Federal Register summarizing the changes it is making in the national Medicare coverage decision-making process. "This was a good, first step in expediting the coverage process by establishing timeframes and clarifying the decision making process," said Fleming. "By addressing the flaws that exist in the coding and payment system, Representative Ramstad's legislation complements HCFA's efforts to reform the coverage process."
Medical technology changes rapidly, with new innovations appearing daily. Ramstad's bill provides five very targeted adjustments in the often technical methods and systems that Medicare uses to adopt and pay for new technology. Among the bill's provisions are mechanisms that will:

Shorten the 15-month or longer timeframe it currently takes to secure a national code for technologies.

Retain local codes that were designed to identify new technologies still waiting for national codes.

Update and adjust payment systems annually to reflect changes in medical practice and technology. For example, HCFA has proposed that the payment categories of the ambulatory surgery center payment system be updated as infrequently as once every five years-clearly inadequate for keeping pace with the extremely short life cycles of emerging medical technologies.

Utilize reliable data from external sources such as private insurers, manufacturers, and suppliers to update payment rates and categories rather than insisting on collecting and using HCFA's own limited data.

Establish an Advisory Committee on Medicare Coding and Payment to examine how coverage, coding and payment systems interact and recommend steps to correct any problems that impede the seamless integration of medical technology into Medicare.

"We are pleased that Representative Ramstad has taken the first step to address the technical, yet very significant problems plaguing the Medicare system," said Fleming. "This legislation will provide Medicare beneficiaries with timely access to medical technologies so they may live longer, healthier lives."

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The Health Industry Manufacturers Association (HIMA) is a Washington, D.C.-based trade association and the largest medical technology association in the world. HIMA represents more than 800 manufacturers of medical devices, diagnostic products, and medical information systems. HIMA's members manufacture nearly 90 percent of the $62 billion of health care technology products purchased annually in the United States, and more than 50 percent of the $147 billion purchased annually around the world.