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US S3914

US S3914
Ensuring Patient Access to Critical Breakthrough Products Act of 2020


summary

Introduced
06/08/2020
In Committee
06/08/2020
Crossed Over
Passed
Dead
12/31/2020

Introduced Session

116th Congress

Bill Summary

A bill to amend title XVIII of the Social Security Act to ensure prompt coverage of breakthrough devices under the Medicare program, and for other purposes. This bill provides for Medicare coverage of medical devices that are approved under the Food and Drug Administration (FDA) Breakthrough Devices Program. (Under the program, manufacturers work with the FDA to expedite the review and approval of certain medical devices that provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating human diseases or conditions.) The bill allows designated medical breakthrough devices to be temporarily covered under Medicare during a three-year transitional period. The Centers for Medicare & Medicaid Services (CMS) must assign payment codes for such devices within three months of FDA approval. The CMS must also establish a process to allow for continued coverage after the transitional period has expired, taking into account any additional evidence or data the CMS deems necessary. The CMS must also provide for temporary and, where appropriate, permanent Medicare coverage of breakthrough devices for which there is no existing benefit category (i.e., classification).

AI Summary

This bill provides for Medicare coverage of medical devices that are approved under the Food and Drug Administration (FDA) Breakthrough Devices Program. The bill allows designated medical breakthrough devices to be temporarily covered under Medicare during a three-year transitional period, and requires the Centers for Medicare & Medicaid Services (CMS) to assign payment codes for such devices within three months of FDA approval. The CMS must also establish a process to allow for continued coverage after the transitional period has expired, taking into account any additional evidence or data the CMS deems necessary. The bill also provides for temporary and, where appropriate, permanent Medicare coverage of breakthrough devices for which there is no existing benefit category.

Committee Categories

Budget and Finance

Sponsors (1)

Last Action

Read twice and referred to the Committee on Finance. (on 06/08/2020)

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