When our loved ones are sick, hurt, or suffering, our instincts kick in. We want them to have the best care and give them the best chance at living a normal life. Thanks to medical innovations made right here in Minnesota, millions of people who live with debilitating or chronic conditions are able to live with a better quality of life. However, under current Medicare rules, some of those innovations aren’t available to many American seniors. A new rule change proposed by the federal government would make new, lifesaving medical breakthroughs available to those who need them, but it might not happen if Washington fails to act quickly.
The new policy is called the Medicare Coverage of Innovation Technology (MCIT), and it already has bipartisan support in Congress. The MCIT applies to “breakthrough” technologies designated by the Food and Drug Administration (FDA), which by definition treat life-threatening or irreversibly debilitating conditions for which there are no treatments, or for which existing treatments are lacking. If approved and adopted by the Biden administration, the MCIT program will allow Medicare to immediately cover these breakthrough technologies so seniors can access them quickly.
The rule is currently stalled and could even be rescinded, making its approval an urgent matter for the new administration and for our seniors. The Minnesota Department of Health found that more than 80 percent of all Minnesota seniors have at least one diagnosed chronic condition. Far too many seniors, both in Minnesota and across the country, are living with conditions for which no treatment options currently exist.
Without the MCIT policy, breakthrough technologies would only be quickly available to seniors with private or supplemental health insurance plans. Those who are either covered only by Medicare, or are among the 156,000 “dual eligible” Minnesotans who also qualify for some level of coverage under Medicaid, already face diminished access to advanced medical treatments. If MCIT is not approved, those treatments will remain out of reach for those Medicare and Medicaid seniors.
MCIT still emphasizes safety and efficacy. It is not a loophole for new innovations to bypass the research and approval process. MCIT allows for a temporary approval that will only happen once a treatment or diagnostic test is approved by the FDA. This review process is considered a global gold standard for medical device safety and efficacy, but under current policies, it still does not guarantee immediate access to breakthrough treatments and tests. The approved technology then must go through another approval process before it is covered by Medicare. That process can take several years. For seniors living with serious medical conditions, that’s a luxury they cannot afford.
A simple change
The new rule is simple – as it should be. Once the FDA does approve a breakthrough technology, Medicare can quickly cover it while the Centers for Medicare and Medicaid Services (CMS) collects real-world data and evidence to assess the impact of these life-altering technologies on Medicare patients.
Medicare beneficiaries deserve access to breakthrough health care technologies as soon as possible. With the proposed rule change, CMS recognizes that patients and doctors should be able to decide the best way to treat serious conditions. We owe it to our most vulnerable family members to move this policy forward with final approval. Furthermore, new Medicare rules should not be limited to breakthrough health care technologies. Seniors across the country deserve Medicare coverage for essential medical devices like hearing aids, insulin equipment, and more.
There’s a reason MCIT has earned support from both sides of the aisle in Congress, and here in Minnesota. It’s good government, good policy, and good common sense. Minnesota is the backbone of America’s medical device industry. Our innovations save lives. We should put them in the hands of the people who need them by advancing, strengthening and finalizing the MCIT – as quickly as possible.