Posted by Michael Wonder on 08 Sep 2023
Protecting Medicare’s discretion to say no to unproven therapies
8 September 2023 - Medicare, the largest health care payer in the nation, is also the single biggest source of revenue for pharmaceutical companies.
Since Medicare’s creation, federal law has restricted the program’s coverage to items and services that are “reasonable and necessary.” Legislation introduced earlier this year, however, takes aim at Medicare’s foundational discretion to decide whether to cover a new product.
