Medical Device Manufacturers Association Reimbursement Survey
Progress: 
  
EXPERIENCE WITH PAYERS FOR COVERAGE DEVELOPMENT
 

What payers have you interacted with to secure coverage for your medical technology? Select all that apply.

Medicare: CMS Central Coverage Analysis Group (CAG) for National Coverage Determination (NCD)
Medicare: Regional Medicare Administrative Contractors (MACs) for Local Coverage Determinations (LCD)
Commercial Payers: National Plans (Aetna, Cigna, Humana, Kaiser Permanente, United Healthcare)
Commercial Payers: State/regional plans, including BCBS plans
None
Other  
For each selected, please indicate which of the following situations posed the greatest to least challenging barrier to securing coverage.
 

Medicare (NCD or LCD)

 Not a Challenge Challenging Very Challenging N/A  
Unclear/inconsistent evidence requirements  
Insufficient explanation of non-coverage decision  
Limited/No access to Policy Medical Directors and Staff  
Inconsistent coverage among different Medicare MACs  
Other: please describe  
  • Comment:

  • 500 characters left.

Commercial payers (all groups)

 Not a Challenge Challenging Very Challenging N/A  
Unclear/inconsistent evidence standards/ requirements  
Insufficient explanation of non-coverage decision that is not linked to specific evidence/references in the coverage policy  
Poor access to Policy Medical Directors and Staff  
Insufficient/ misaligned economic value justification  
Inconsistent coverage among different commercial payers  
Other: please describe  
  • Comment:

  • 500 characters left.

All other payers:

 Not a Challenge Challenging Very Challenging N/A  
Unclear/inconsistent evidence standards/ requirements  
Insufficient explanation of non-coverage decision that is not linked to specific evidence/references in the coverage policy  
Differing requirements from traditional Medicare/commercial payers  
Poor access to Policy Medical Directors and Staff  
Insufficient/ misaligned economic value justification  
Other: please describe  
  • Comment:

  • 500 characters left.

For Medicare, the time from commercial launch to secure coverage was:

More than 5 years
3-4 years
1-2 years
less than 12 months
I have not interacted with Medicare to secure coverage for my medical technology
For commercial payers, the time from commercial launch to secure coverage was:
More than 5 years
3-4 years
1-2 years
Less than 12 months
I have not interacted with commercial payers to secure coverage for my medical technology

For all other payers, the time from commercial launch to secure coverage was:

More than 5 years
3-4 years
1-2 years
Less than 12 months
I have not interacted with all other payers to secure coverage for my medical technology

Please select your level of agreement with the following statement:
Clinical guidelines or practice pattern recommendations from medical specialty societies have influence on the coverage determinations for medical technologies.

Strongly disagree Slightly disagree Slightly agree Strongly agree        
       

Please select your level of agreement with the following statement:

Third-party technology assessment bodies (e.g. Hayes, ECRI, NICE, etc.) have influence on the coverage determinations for medical technologies.

Strongly disagree Slightly disagree Slightly agree Strongly agree