The Centers for Medicare and Medicaid Services seeks to deny coverage for an artificial spinal disk called Charite. Lack of evidence that the surgery required to implant the disk is “reasonable and necessary” is the reason, says CMS.
From Kaiser Network’s report:
The proposal to deny Medicare coverage for Charite could prompt private health insurers to take similar actions. According to the Journal, such actions would represent a “rare setback” for J&J, which has “excelled at persuading insurers to pay for new technology.”
As baby boomers age and technological advancements improve existing medical devices and create new ones, expect similar clashes between the health care industry, private insurers, and government insurers like Medicare. We should encourage innovation, but the question will always be, “Who is going to pay for it?”
