The report, The Medicare Payment Process and Patient Access to Technology, for the first time comprehensively analyzes the problems in Medicare's procedures for making new technologies available to beneficiaries and describes with quantifiable information their impact on patient access and utilization. It finally took an act of Congress to provide this technology to Medicare patients.
Cochlear implants can restore hearing to people with severe hearing loss.
Medicare patients face significant barriers to receiving cochlear implants because Medicare has not updated its inadequate reimbursement for the device for 14 years. Proportionally, of all the people who could benefit from cochlear implants, far fewer Medicare patients than non-Medicare patients have received them. Fifty four percent of all patients eligible to receive cochlear implants are Medicare age, but only 12 percent to 15 percent of implant recipients are Medicare patients. Importantly, The Lewin Group also points out that small companies are particularly vulnerable to hurdles posed by Medicare's uncoordinated and time- consuming processes. Small medical technology innovators often have fewer resources to invest in gathering additional data beyond that required by FDA, pursuing national or local coverage decisions, and obtaining coding and adequate payment.