Coverage, technology assessment, and the courts.
Coverage decisions by third-party payers are relying more and more heavily on the conclusions of technology assessment programs about the safety and effectiveness of technologies applied in specific clinical situations. Assessment programs vary markedly in the sophistication and rigor of their methodology. Payers differ as to how such assessment information is integrated into their decision-making processes. Finally, coverage decisions about a specific technology can vary widely across the country.
McGivney
W T
WT
American Medical Association, Chicago, IL.
D054598:Blue Cross Blue Shield Insurance Plans / Q000331:legislation & jurisprudence; D002140:California; D007345:Insurance Claim Review / Q000331:legislation & jurisprudence*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D008484:Medicaid / Q000331:legislation & jurisprudence; D013673:Technology Assessment, Biomedical / Q000191:economics; D014481:United States; D014768:Virginia; D014922:Wisconsin