Intellectual Property Advisory: Payment for New Health Care Technologies- The Long and Winding Road
3/1/2002
The road from development of a new medical technology to payment is long, difficult and treacherous. The process involves three distinct steps: regulatory approval process, obtaining coverage for a product, and the determination of the coverage amount for the new product. As a result of the increasing complexity of medical practice and the legal implications of making incorrect or unsupported decisions, most insurers have established rigorous formal review processes in contrast to the ad hoc processes of the past. Despite constructive steps towards creating a comprehensive national coverage process in 1999, Medicare's review process, remains a work in progress. The best advice for companies attempting to negotiate this complex process is to have a clear understanding of its various components, their interrelationships, and their goals.
