Earlier this month, the American Association of Health Plans told its members to adopt binding review programs allowing patients to quickly challenge coverage decisions. That trade group also is about to sign an agreement with the National Institutes of Health urging its members to pay for the patient-care costs involved in clinical trials of experimental procedures and treatments. It would make it much more comfortable for a lot of people if there was a neutral party, making decisions. Company officials say they don't consider economics in these decisions as much as whether a treatment is safe and effective. In most companies, a committee determines what technology is experimental.
Insurers say they insist on random tests of new treatments in many centers.
They want to know whether the new treatment is as effective as the standard treatment, whether it's safe and whether the test results can be achieved outside of the lab. There are horror stories of experiments that jumped the gun. Several years ago, new drugs did wonders for people who had extra heartbeats. Those drugs also were given to people who had extra heart beats after suffering heart attacks. You think you're doing good.