FOR IMMEDIATE RELEASE
July 19, 1999CONTACT: Linda Ruckel (202) 434-7243
Bahar Morid (202) 434-7273
INNOVATORS OF MEDICAL TECHNOLOGY APPLAUD
THE MEDICARE APPEALS ACTWASHINGTON, DC - The Health Industry Manufacturers Association (HIMA) urged Congress to put "The Medicare Appeals Act of 1999" on the legislative fast track. The legislation, HR 2356, introduced by Representatives William Thomas (R-CA), Chairman of the House Ways and Means Health Subcommittee and its Ranking Member Representative Pete Stark (D-CA), enhances the rights of Medicare patients in appealing decisions made by the Health Care Financing Administration (HCFA) and its local contractors to not pay for an innovative and new technology.
"American researchers, scientists and innovators are working to discover new medical technology that will save and enhance patients' lives," said Pam Bailey, HIMA president. "It is unconscionable that bureaucratic delays and red tape prevent Medicare from providing some beneficiaries access to innovative treatments for years after FDA has approved these same treatments. This bill will address these problems by making the appeals process clearer, more effective and timely. The result - Medicare will provide patients more timely access to needed medical technologies."
Appeals decisions are a critical element of the overall Medicare coverage process because they help determine whether or not Medicare makes medical products available to Medicare beneficiaries.
Other key provision of the bill include:
- Imposes timeframes that would cut in half the amount of time it now takes for beneficiary coverage appeals to be heard.
- Establishes a new patient right to external review of HCFA's national coverage determinations.
- Allows Medicare patients and others, including technology manufacturers, to appeal the underlying policy basis for local coverage decisions. This would permit resolution of the fundamental issue in dispute prospectively for all current and future beneficiaries in a local contractor's area, thereby replacing the current, inefficient, claim-by-claim appeals process.
"Thank you to Chairman Thomas and Representative Stark for your leadership in bringing to light this critical and highly complex issue that has been buried deep in the bureaucracy," said Bailey. "You have developed a real solution. And, thank you to the patients and doctors who have fought for the changes which this bill incorporates. Your waiting is almost over."
### 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.